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Methicillin-resistant Staphylococcus aureus as a uropathogen in an Irish setting
Aisling T Looney1, Elaine J Redmond, Naomi M Davey
1Department of Urology, University Hospital Waterford, Waterford Department of Urology, University College Hospital Galway, Galway Department of Microbiology, University Hospital Waterford, Waterford, Ireland.
Medicine
|April 7, 2017
Summary
Methicillin-resistant Staphylococcus aureus (MRSA) in urine is a growing concern. Nitrofurantoin and Vancomycin/Teicoplanin show promise for treating MRSA urinary tract infections, while fluoroquinolones should be avoided.
Area of Science:
- Microbiology
- Infectious Diseases
- Clinical Pharmacy
Background:
- Urinary tract infections (UTIs) are common, complicated by drug-resistant pathogens.
- Colonization of urinary catheters by microbes poses treatment challenges.
- Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging threat in healthcare settings.
Purpose of the Study:
- To assess the occurrence and antimicrobial susceptibility of MRSA in urine.
- To analyze MRSA resistance patterns over five years (2010-2014).
- To guide treatment strategies for MRSA UTIs.
Main Methods:
- Retrospective review of 151 MRSA urine isolates from 128 patients.
- Analysis of isolates from various clinical subgroups (inpatients, ED, GP referrals, nursing homes).
- Calculation of antimicrobial resistance rates for standard agents.
Main Results:
- 100% resistance to Flucloxacillin and Co-amoxiclav observed.
- 98% resistance to Ciprofloxacin; 7.4% resistance to Trimethoprim.
- Low resistance (2.7%) to Nitrofurantoin; 100% sensitivity to Teicoplanin and Vancomycin.
Conclusions:
- Urinary MRSA is an understudied but critical issue.
- Nitrofurantoin is suitable for well patients; Vancomycin/Teicoplanin for unwell patients.
- Fluoroquinolones should be avoided due to high resistance rates in MRSA UTIs.