[MRSA bacteremia: recent epidemiological and therapeutical trends].
OBJECTIVE
Staphylococcus aureus is the first agent responsible for nosocomial bacteremia in France. About 40% of the strains are resistant to methicillin (MRSA). The epidemiology of these infections has changed in the last fifteen years whereas therapeutics options have slightly progressed.


BACKGROUND
Hospital-acquired MRSA bacteremia are more and more frequent while community-acquired strains recently appeared. Factors influencing the emergence of these infections were identified thanks to numerous clinical studies, as well as patients risk factors for developing these infections and their complications. At the same time, intermediate sensitive and resistant MRSA strains to glycopeptides appeared. Conversely, the best antibiotic strategy is still unclear in absence of good clinical studies. The interest of antibiotics combinations and of glycopeptides serum-concentrations control is still a matter of debate. Finally, the number of new active molecules remains limited.


CONCLUSIONS
The frequency and severity of MRSA bacteremia are quite worrying in our country. The epidemiology of these infections must be known by every clinicians in order to prevent them. The therapeutic strategy has to be better define and need for new anti-infectious agents is critic.
Forestier
E
E
Service de médecine interne et maladies infectieuses et tropicales, médicale A, 1, place de l'Hôpital, 67000 Strasbourg, France. emmanuel.forestier@chru-strasbourg.fr
Rémy
V
V
Mohseni-Zadeh
M
M
Lesens
O
O
Jauhlac
B
B
Christmann
D
D
Hansmann
Y
Y
D016470:Bacteremia / Q000175:diagnosis / Q000453:epidemiology*; D001426:Bacterial Proteins / Q000187:drug effects / Q000235:genetics; D003428:Cross Infection / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005602:France / Q000453:epidemiology; D006801:Humans; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D046915:Penicillin-Binding Proteins / Q000187:drug effects / Q000235:genetics; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000187:drug effects*
D001426:Bacterial Proteins; D046915:Penicillin-Binding Proteins; C487789:mecA protein, Staphylococcus aureus