Escalation of antimicrobial resistance among MRSA part 2: focus on infections and treatment
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Published on: September 27, 2024
Joseph P Lynch1, George G Zhanel2
1Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, Department of Internal Medicine, the David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Introduction:
MRSA is associated with causing a variety of infections including skin and skin structure infections, catheter and device-related (e.g. central venous catheter, prosthetic heart valve) infections, infectious endocarditis, blood stream infections, bone, and joint infections (e.g. osteomyelitis, prosthetic joint, surgical site), central nervous system infections (e.g. meningitis, brain/spinal cord abscess, ventriculitis, hydrocephalus), respiratory tract infections (e.g. hospital-acquired pneumonia, ventilator-associated pneumonia), urinary tract infections, and gastrointestinal infections. The emergence and spread of multidrug resistant (MDR) MRSA clones has limited therapeutic options. Older agents such as vancomycin, linezolid and daptomycin and a variety of newer MRSA antimicrobials and combination therapy are available to treat serious MRSA infections.
Areas Covered:
The authors discuss infections caused by MRSA as well as common older and newer antimicrobials and combination therapy for MRSA infections. A literature search of MRSA was performed via PubMed (up to September 2022), using the keywords: antimicrobial resistance; β-lactams; multidrug resistance, Staphylococcus aureus, vancomycin; glycolipopeptides.
Expert Opinion:
Innovation, discovery, and development of new and novel classes of antimicrobial agents are critical to expand effective therapeutic options. The authors encourage the judicious use of antimicrobials in accordance with antimicrobial stewardship programs along with infection-control measures to minimize the spread of MRSA.
Insights
Multidrug-resistant Staphylococcus aureus (MRSA) causes diverse infections, limiting treatment options. New antimicrobial agents and judicious use are crucial for combating MRSA infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen causing a wide spectrum of infections, including skin, device-related, bloodstream, bone and joint, central nervous system, respiratory, urinary, and gastrointestinal infections.
- The emergence of multidrug-resistant (MDR) MRSA strains has severely restricted available therapeutic options, necessitating a review of current and emerging treatments.
Purpose of the Study:
- To review current and emerging antimicrobial therapies for MRSA infections.
- To highlight the importance of antimicrobial stewardship and infection control in managing MRSA.
Main Methods:
- A literature search was conducted on PubMed up to September 2022.
- Keywords used included: antimicrobial resistance, β-lactams, multidrug resistance, Staphylococcus aureus, vancomycin, and glycolipopeptides.
Main Results:
- MRSA infections encompass a broad range of clinical manifestations.
- Existing treatments include older agents like vancomycin, linezolid, and daptomycin, alongside newer antimicrobials and combination therapies.
- The development of novel antimicrobial classes is critical to address resistance.
Conclusions:
- Effective management of MRSA infections requires a combination of innovative antimicrobial development and strategic use of existing therapies.
- Antimicrobial stewardship programs and infection-control measures are essential to curb the spread of MRSA.
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