Staphylococcus aureus community-acquired

Viridans streptococci, Streptococcus bovis, HACEK group, Staphylococcus aureus, or community-acquired enterococci in the absence of a primary focus, or... 

Methicillin-resistant Staphylococcus aureus (MRSA) is a common hospital-acquired pathogen and is also increasing in the community. MRSA has presented a problem in the past because it required treatment with vancomycin. Community-acquired MRSA presents a major therapeutic challenge. MRSA can cause pneumonia, cellulitis, and other infections. Clinicians should be aware of the rate of hospital and community MRSA in your geographic area. New treatment options are available for MRSA. They include linezolid, tigecycline, and daptomycin. Prospective clinical trials have not demonstrated benefits of these agents over vancomycin.36-37... 

Community-acquired pneumonia For the treatment of community-acquired pneumonia caused by Streptococcus pneumoniae (penicillin-susceptible strains only), including cases with concurrent bacteremia, or Staphylococcus aureus (methicillin-susceptible strains only). 

Levofloxacin (1), the levo-isomer or the (5)-enantiomer of ofloxacin, received FDA approval in 1996 (Fish, 2003 Hurst et al., 2002 Mascaretti, 2003 Norrby, 1999 North et al., 1998). The initial approval covered community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, acute maxillary sinusitis, uncomplicated skin and skin structure infections, acute pyelonephritis, and complicated urinary tract infections (North et al., 1998). Four years later, the levofloxacin indication list grew to include community-acquired pneumonia caused by penicillin-resistant Streptococcus pneumoniae. In addition, in 2002, nosocomial (hospital-acquired) pneumonia caused by methicillin-susceptible Staphylococcus aureus, Pseudomonas aeruginosa, Serratia marcescens, Haemophilus influenzae, Kliebsella pneumoniae, and Escherichia coli was added (Hurst et al., 2002). Finally in 2004, LVX was approved as a post-exposure treatment for individuals exposed to Bacillus anthracis, the microbe that causes anthrax, via inhalation (FDA, 2004). 

The need for new antibiotics is driven by the recent rise in the incidence of resistance to commonly used antibiotics. The emergence of multiple-drug resistance to community-acquired infections, such as those caused by Streptococcus pneumoniae, is particularly alarming due to the ease of transmission [1-4], Recent reports show that methicillin-resistant Staphylococcus aureus, the common cause of hospital-acquired infections, has also moved into the community [5],... 

Centers for Disease Control and Prevention. Four pediatric deaths from community-acquired methicillin-resistant Staphylococcus aureus—Minnesota and North Dakota, 1997-1999. Morb Mortal Wkly Rep 48 707-710, 1999. 

Due to its powerful specific activity against commonly isolated community-acquired respiratory tract pathogens [33,149-158], including penicillin-sensitive and -resistant Streptococcus pneumoniae, methicillin-sensitive Staphylococcus aureus, Haemophilus spp., Moraxella catarrhalis and atypical pathogens such as Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophila and Klebsiella pneumoniae and anaerobic bacteria [159-162], moxifloxacin was developed as a respiratory tract anti-infective [163-168]. 

Other less common pathogens include Staphylococcus aureus, Haemophilus influenzae and Gram-negative rods from the gastrointestinal tract. In severe community-acquired pneumonia, these pathogens must also be covered due to the high risk of mortality, hence the use of more broad-spectrum cephalosporins... 

Diep BA, GUI SR, Chang RF, Phan TH, Chen JH, Davidson MG, Lin F, Lin J, Carleton HA, Mongodin EF, Sensabaugh GF, Perdreau-Remington F (2006) Complete genome sequence of USA300, an epidemic clone of community-acquired meticillin-resistant Staphylococcus aureus. Lancet 367 731-739... 

Strommenger B, Braulke C, Pasemann B, Schmidt C, Witte W (2008b) Multiplex PCR for rapid detection of Staphylococcus aureus isolates suspected to represent community-acquired strains. J Clin Microbiol 46 582-587... 

Takano T, Higuchi W, Otsuka T, Baranovich T, Enany S, Saito K, Isobe H, Dohmae S, Ozaki K, Takano M, Iwao Y, Shibuya M, Okubo T, Yabe S, Shi D, Reva I, Teng LJ, Yamamoto T (2008) Novel characteristics of community-acquired methiciUin-resistant Staphylococcus aureus strains belonging to multilocus sequence type 59 in Taiwan. Antimicrob Agents Chemother... 

Pneumonia—Community-acquired bacterial pneumonia is frequently caused by Streptococcus pneumoniae (pneumococci). In the United States, more than 15% of recent isolates of S. pneumoniae are highly resistant to penicillin and increasingly resistant to cephalosporins, macrolides, and less commonly to fluoroquinolones. Other bacterial pathogens include Haemophilus influenzae. Staphylococcus aureus, Klebsiella pneumoniae, and, occasionally, other Gramnegative bacilli and anaerobic mouth organisms. Atypical ... 

Azithromycin, an azalide macrolide antibiotic (500 mg p.o. as a single dose on day 1, followed by 250 mg daily on days 2 to 5 total accumulation dose is 1.5 g), is indicated in the treatment of acute bacterial exacerbations of chronic obstructive pulmonary disease caused by Haemophilus influenzae, Moraxella (Branhamella) catarrhalis, or Streptococcus pneumoniae mild community-acquired pneumonia caused by H. influenzae or S. pneumoniae uncomplicated skin and skin-structure infections caused by Staphylococcus aureus, Streptococcus pyogenes, or S. agalactiae second-line therapy of pharyngitis or tonsillitis caused by S. pyogenes and in nongonococcal urethritis or cervicitis caused by Chlamydia trachomatis. 

Kowalski, T. J., Berbari, E. F., and Osmon, D. R. (2005) Epidemiology, treatment and prevention of community-acquired methiciUin-resistant Staphylococcus aureus infections. Mayo Clin. Proc. 80, 1201-1208. 

Said-Salim, B., Mathema, B., and Kreiswirth, B. N. (2003) Community-acquired methicillin-resistant Staphylococcus aureus an emerging pathogen. Infect. Control Hosp. Epidemiol. 24, 451-455. 

According to the time of diagnosis, VAP can be subdivided into early-onset (diagnosed within the first 4 days of ventilation) and late-onset disease (diagnosed after more than 4 days of ventilation) (11). Early-onset VAP is usually caused by community-acquired bacteria colonizing the upper respiratory tract before hospital admission (e.g.. Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus), these are presumably aspirated... 

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