Mrsa research paper
For methicillin-resistant staphylococcus aureus (mrsa): future research needsidentification of future research needs from comparative effectiveness review no. 40investigators: hussein z noorani, ms, elizabeth adams, mph, susan glick, md, stephen weber, md, suzanne belinson, phd, mph, and naomi aronson, cross and blue shield association technology evaluation center evidence-based practice centerrockville (md): agency for healthcare research and quality (us); 2013 no. For more information, see the bookshelf copyright term excerptmethicillin-resistant staphylococcus aureus (mrsa) emerged as a clinically relevant human pathogen more than 5 decades ago. Mrsa emerged as an important cause of health care-acquired infections, particularly central line-associated bloodstream infection, ventilator-associated pneumonia, and surgical site e the adoption of infection control measures, the incidence of mrsa infection at most hospitals in the united states (u. Active surveillance screening for mrsa is receiving greater attention for its potential value in identifying carriers of mrsa to prevent further identify the population of colonized individuals, microbiological samples are obtained from at-risk patients even in the absence of signs or symptoms of infection. Hand hygiene and contact isolation) can be implemented in a broader and timelier manner to interrupt horizontal transmission of mrsa. Comparative effectiveness review (cer) was prepared by the blue cross and blue shield association technology evaluation center evidence-based practice center (bcbsa tec epc) on screening for methicillin-resistant staphylococcus aureus (mrsa). The objective of the cer was to synthesize comparative studies that examined the benefits or harms of screening for mrsa carriage in the inpatient or outpatient settings. The review examined mrsa-screening strategies applied to all hospitalized or ambulatory patients (universal screening), as well as screening strategies applied to selected inpatient or outpatient populations (e. Patients admitted to the intensive care unit (icu), patients admitted for a surgical procedure, or patients at high-risk of mrsa colonization or infection such those on prolonged antibiotic therapy) and compared them to no screening or to screening of selected patient populations (targeted screening). The review evaluated mrsa-screening strategies with or without isolation and with or without attempted eradication/tsexpand allcollapse allprefaceacknowledgmentsstakeholder panelexecutive summaryintroductionbackgroundmethodsidentification of research needsliterature search updatecriteria for prioritizationresultsresearch needsresearch questionsstudy design considerationsdiscussion and conclusionsreferencesabbreviationsappendix a summary of evidence from draft comparative effectiveness reviewappendix b search strategies for updating of evidenceappendix c survey tool used to rate research needsappendix d survey tool used to rate research questionsappendix e list of research needsappendix f survey results of research needsappendix g survey results of research questionsexpand allcollapse allprepared for:Agency for healthcare research and quality, u. Report is based on research conducted by the blue cross and blue shield association technology evaluation center evidence-based practice center (epc) under contract to the agency for healthcare research and quality (ahrq), rockville, md (contract no.
Department of health and human information in this report is intended to help health care researchers and funders of research make well-informed decisions in designing and funding research and thereby improve the quality of health care services. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical research and in conjunction with all other pertinent information, i. Screening for methicillin-resistant staphylococcus aureus (mrsa): future research needs: identification of future research needs from comparative effectiveness review no. Review screening for methicillin-resistant staphylococcus aureus (mrsa)[ 2013]review screening for methicillin-resistant staphylococcus aureus (mrsa)glick sb, samson dj, huang e, vats v, weber s, aronson n. For methicillin-resistant staphylococcus aureus (mrsa): future research needsyour browsing activity is ty recording is turned recording back onsee more... Paper virus research papers examine methicillin-resistant staphylococcus aureus bacteria that infects the cells of an is an acronym for methicillin-resistant staphylococcus aureus bacteria. Bacteria are living organisms, while debate rages whether viruses are alive or organic structures that interact with living y of mrsa mrsa bacterium was first identified in 1961, approximately two years after the antibiotic methicillin was introduced to treat s. Fortunately, new guidelines for prevention practices in hospitals have reduced mrsa deaths by 54% between 2005 and 2011, according to the centers for disease control. However, in 2011 there were still 80,000 mrsa infections that resulted in 11,000 resulted as a mutation in the bacteria and it continues to evolve. There are many mrsa strains that are resistant to many antibiotics including:As a result of the speed of mrsa mutations, and its resistance to most modern antibiotics, it is often referred to as a “superbug. Some forms of mrsa are called “flesh-eating bacteria” because of their rapid spread and destruction of human d research paper in sports - methicillin-resistant staphylococcus aureus (mrsa) is a strain of bacteria that is resistant to most common forms of antibiotic gy of mrsa research papers discuss the studies on methicillin-resistant staphylococcus aureus, a bacterium that causes infections in the treatment research papers examine the treatments used to treat methicillin-resistant staphylococcus to write a research paper on mrsa page is designed to show you how to write a research project on the topic you see to the left. Use our sample or order a custom written research paper from paper research papers - custom written research papers on any topic you need starting at $23.
Per research paper services - learn about all of paper masters' custom research paper and writing your research paper worries in less than 5 minutes! A custom research paper on any online teed quality -time delivery via ential & masters - showing students how to write quality research papers for over 19 masters custom research papers on mrsa masters writes custom research papers on mrsa virus and examine methicillin-resistant staphylococcus aureus bacteria that infects the cells of an organism. Per page - order paper faqs e-mail ch paper virus research papers examine methicillin-resistant staphylococcus aureus bacteria that infects the cells of an is an acronym for methicillin-resistant staphylococcus aureus bacteria. Per page - order paper faqs e-mail are working on a new version of this page and we'd like your an early preview article has open peer review reports does open peer review work? Peer review ining whether methicillin-resistant staphylococcus aureus (mrsa) is a true causative pathogen or reflective of colonization when mrsa is cultured from the respiratory tract remains important in treating patients with evaluated the bacterial microbiota in bronchoalveolar lavage fluid (balf) using the clone library method with a 16s ribosomal rna (rrna) gene analysis in 42 patients from a pneumonia registry who had mrsa cultured from their sputum or balf samples. Patients were divided into two groups: those treated with (group a) or without (group b) anti-mrsa agents, and their clinical features were 248 patients with pneumonia, 42 patients who had mrsa cultured from the respiratory tract were analyzed (group a: 13 patients, group b: 29 patients). Twenty-eight of 29 patients in group b showed favorable clinical outcomes, indicating that these patients had non-mrsa pneumonia. Aureus phylotype and risk factors of mrsa molecular method using balf specimens suggests that conventional cultivation method results may mislead true causative pathogens, especially in patients with mrsa pneumonia. Further studies are necessary to elucidate these clinically important ds16s rrna genemethicillin-resistant staphylococcus aureus, mrsaclone librarycontaminationpneumoniabronchoalveolar lavage, oundpatients with nosocomial pneumonia caused by methicillin-resistant staphylococcus aureus (mrsa) have been increasing over the past half century. Approximately 20–40 % of all hospital-acquired pneumonia (hap), ventilator-associated pneumonia (vap) [1, 2] and the number of mrsa pneumonia patients is increasing in step with aging of the population [3]. Several guidelines [4, 5], including japanese guidelines for nursing and healthcare-associated pneumonia (nhcap) [6] and hap [7, 8], suggest the use of anti-mrsa antimicrobials in pneumonia patients when the risks of mrsa are suggested. However, there have been only a few clinical studies that describe the pathogenicity of mrsa in bacterial pneumonia and accurate diagnostic methods for evaluating mrsa pneumonia [9–11].
Generally, the diagnostic criteria of respiratory infection caused by mrsa are positive results of a quantitative culture of mrsa over 106 colony forming units (cfu)/ml in sputum samples, 104 cfu/ml in lower respiratory specimens and/or phagocytosis of s. However, it is occasionally difficult to differentiate whether the detected mrsa is a true causative pathogen of pneumonia or only reflective of colonization when mrsa is cultured from the lower respiratory tract samples. Physicians should carefully consider whether or not cultured mrsa is actually causative in each case because many patients fulfill these criteria and improve without anti-mrsa agents in real-world clinical settings. Differentiation of mrsa as a cause of pneumonia or merely colonization remains an important clinical issue and is of a particular interest in clinical hypothesized that the percentage of s. Aureus clones in bronchoalveolar lavage fluid (balf) directly obtained from the affected lesions of pneumonia identified by chest ct might be helpful to distinguish true mrsa pneumonia from colonization of mrsa. In the present study, we used the data from the pneumonia registry, which included 16s ribosomal rna gene analyses of balf, and patients with pneumonia in whom mrsa was cultured from the respiratory samples were enrolled. Then we divided these patients into two groups: group a included mrsa pneumonia patients treated with anti-mrsa agents and group b were patients with mrsa cultured from respiratory samples but who improved without anti-mrsa treatment, and the clinical features of these two groups were 248 japanese patients with community-acquired pneumonia (cap), healthcare-associated pneumonia (hcap) and hap at the university of occupational and environmental health, japan and referred hospitals between april 2010 and january 2015, 42 patients with positive cultures for mrsa from respiratory specimens (i. Patients who had mrsa positively cultured from respiratory specimens were divided into two groups: group a consisted of patients that had been treated with anti-mrsa agents, and group b included patients that had been treated without anti-mrsa agents, and the clinical features of these two groups were compared. Cap: community-acquired pneumonia, hcap: healthcare-associated pneumonia, hap: hospital-acquired pneumonia, mrsa: methicillin-resistant staphylococcus aureus, balf: bronchoalveolar lavage diagnosis of pneumonia was made by the fulfillment of the following three criteria: (1) at least one of the following clinical symptoms (a fever ≥ 37 °c, cough, purulent sputum, moist rales, pleural pain, dyspnea, or tachypnea); (2) new infiltrates on a chest x-ray or computed tomography (ct); and (3) at least one sign of systemic inflammation (a white blood cell (wbc) count > 10,000/mm3 or < 4,500/mm3 or an increased c-reactive protein (crp) level). Physicians followed the guidelines for cap, hcap and hap to use anti-mrsa agents as the first antimicrobial treatment. As the present study was a retrospective cohort study, there were no strict criteria that regulate an intervention of anti-mrsa therapy as an additive antibiotic treatment, but clinical response to antibiotics was firstly evaluated three days after the start of antimicrobial treatment, physicians decided to add anti-mrsa agents when the clinical response to antimicrobials were ineffective with positive culture results for ia for the identification of bacterial iological evaluation using cultivation ation of balf and sputum samples was performed as previously described [12, 13]. Mrsa was identified if the minimum inhibitory concentration of oxacillin was ≥ 4 μg/ cell count, cell lysis efficiency analysis and bacterial identification using the molecular tion of the radiologic x-rays or ct performed within 48 h of the onset of pneumonia were analyzed and evaluated by two experienced respirologists without any clinical information.
Was considered statistically al characteristics and laboratory findings of the clinical characteristics and laboratory findings of 42 patients from whom mrsa was detected are shown in table 1. In these 42 patients, the risk factors of mrsa, such as the use of corticosteroid or immunosuppressants (14. Clinical characteristics and laboratory findings of 42 patients treated with or without anti-mrsa drugs in this ± sd (years)74. Standard deviation, copd chronic obstractive pulmonary disease, ntm nontuberculous mycobacterial infection, mrsa methicillin-resistant staphylococcus aureus, ecog eastern cooperative oncology group, cap community-acquired pneumonia, hcap helathcare-associated pneumonia, hap hospital-acquired pneumonia, ct computed tomography, dpb diffuse pulmonary bronchiolitis, ards acute respiratory distress syndrome. Cultivation results demonstrated that mrsa were isolated in all 19 patients in whom sputum culture was performed, and 37 of 41 (90. Pipctaz/iations: cap community-acquired pneumonia, healthcare-associated pneumonia, hap hospital-acquired pneumonia, vap ventilator-associated pneumonia, mrsa methicillin-resistant staphylococcus aureus, balf bronchoalveolar lavage fluid, abk arbekacin, vcm vancomycin, teic teicoplanin, lzd linezolid, ipm/cs imipenem/cilastatin, mepm meropenem, drpm doripenem, bipm biapenem, czop cefozopran, sbt/abpc sulbactam/ampicillin, taz/pipc tazobactam/piperacillin, cpfx ciprofloxacin, lvfx levofloxacin, grnx garenoxacin, mino minomycin, cldm clindamycin, l-amb liposomal amphotericin b, na not group b, 96. Of patients (28 of 29, cases 14–16, 18–42) showed good clinical outcomes without anti-mrsa antimicrobials; one patient (case 17) died because of asphyxiation due to tracheobronchial secretion. Aureus phylotype and risk factors of mrsa 3 shows the relationship between the percentage of clones of the s. Unknown data in three cases, **“positive” and “negative” indicate the number of patients with or without each risk factor, iations: mrsa methicillin-resistant staphylococcus sionwe analyzed the cultivation results and bacterial phylotypes according to the molecular method using balf samples in patients with mrsa cultured from respiratory samples, and interestingly, no clones of s. Treated without anti-mrsa antimicrobials (group b) showed favorable clinical outcomes despite the cultivation of mrsa, and these 28 patients were suspected to have non-mrsa pneumonia; the cultured mrsa from the respiratory samples might have been due to colonization in the respiratory tract. Several previous reports have described that mrsa is occasionally a non-causative pathogen of pneumonia in some patients [23–26] even when mrsa is cultured from sputum samples, and our results suggest that even when mrsa was cultured using samples obtained from the lower respiratory tract, mrsa was clinically considered not to be a causative agent in more than two-thirds of these patients. 36/70) of the patients were considered to have true mrsa pneumonia when hospital-acquired mrsa pneumonia was defined according to the positive responses and/or clinical demand of anti-mrsa agents with a positive culture of mrsa and detection of clustered gram-positive cocci within polymorphonuclear cells in the respiratory samples, such as balf or transthoracic aspiration [11].
28/42) of the patients were possibly considered to have mrsa colonization, and mrsa was considered to be a causative pathogen in 33. These data suggest that it remains clinically controversial whether or not mrsa is a true causative pathogen of pneumonia, even in patients with mrsa cultured from the lower respiratory samples, and the ratio of true mrsa pneumonia in these patients might be lower than previously of 28 (17. Patients in group b who showed good clinical outcomes without anti-mrsa agents demonstrated that the s. Aureus phylotype was predominant among the detected bacterial phylotypes in the samples, which may be inconsistent with the colonization of mrsa. The molecular method we used could not evaluate drug resistance, and a differentiation between mrsa and methicillin-susceptible s. In addition, there are presently no criteria to differentiate causative pathogens using the ratio of bacterial phylotypes in the samples, thus careful discretion is necessary to interpret these data, and further studies are needed to elucidate this l guidelines [4, 6–8] and clinical trials [11] have described the risk factors of mrsa pneumonia. 11] that used a multiple regression analysis for the risk factors of mrsa, a past history of head and neck, esophageal or stomach surgery (odds ratio (or) 8. Aureus (table 3), suggesting that such condition may be a clue to avoid an abuse of anti-mrsa analysis using the 16s rrna gene can detect only bacterial dna, and does not equally indicate that the detected bacterial phylotype causes bacterial infection. Further investigations should be considered to elucidate the data in younger sionwe evaluated the clinical course and the ratios of bacterial phylotypes in balf specimens using the clone library method and conventional cultivation methods in patients with mrsa detected by cultivation from respiratory samples. The results of this study demonstrated that these patients were heterogeneous, and approximately two-thirds of these patients might be considered to have mrsa colonization or non-mrsa pneumonia. In addition, the results of the cultivation-independent molecular method we used indicated that the detection of mrsa by cultivation methods may not correctly reflect the pathogenicity of mrsa in patients with pneumonia. Further prospective studies are necessary to elucidate the pathogenicity of mrsa in approval and consent to study was approved by the human and animal ethics review committee of the university of occupational and environmental health, japan (no.
