The role of MRSA in healthcare-associated pneumonia.
An important continued trend in healthcare-associated infection, including healthcare-associated pneumonia (HCAP), is the rise of methicillin-resistant Staphylococcus aureus (MRSA). The emergence of community-acquired strains of MRSA has complicated the management further. We review likely risk factors for MRSA HCAP, which include prior antibiotic therapy, nasal colonization, poor infection control practices, and antecedent viral infection. The multiple mechanisms of antibiotic resistance are also described, and virulence factors that may affect antibiotic choices are discussed. The limitations of vancomycin and evidence for superior outcomes with linezolid are reviewed. Alternatives for community-acquired strains and future options are mentioned.
Lam
Anna P
AP
Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
Wunderink
Richard G
RG
D000890:Anti-Infective Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D006020:Glycopeptides / Q000627:therapeutic use; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000472:pathogenicity*; D023303:Oxazolidinones / Q000627:therapeutic use; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D014774:Virulence
D000890:Anti-Infective Agents; D006020:Glycopeptides; D023303:Oxazolidinones