Tag: MRSA

Ahorita-que? The New Gram Positive Antibiotic, Oritavancin

Vancomycin is the work-horse antibiotic every person reaches for. It is a glycopeptide that covers a wide range of gram positive bacteria, with its niche being in its coverage of methicillin-resistant staphylococcus aureus and Enterococcus spp. It is bacteriostatic, with dosing issues and highly nephrotoxic, however it is ubiquitous throughout any hospital in the United

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The Microbiology of Diabetic Foot Infections – What I Didn’t Know

This and (likely) the next post are a product of questions I got asked. For instance, do you need anaerobic coverage for diabetic foot infections? Depends, but see later. What organisms do you need to cover for cellulitis in those who have had water exposure? Cephalexin and quinolones, with some exceptions. We will talk about

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Daptomycin for Septic Pulmonary Emboli? Maybe

The hits keep coming and they don’t stop coming. I’ve had a bit of a lull lately, but am back to bring short, and hopefully, sweet post. Daptomycin has become a go-to antibiotic for MRSA infections, namely bacteremia, as organisms with resistance to vancomycin have risen in the past few years. The 2006 Fowler study

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What the MRSA PCR? The Role of Nose PCR Swabs in Stewardship.

I recently wrote about the fact that all pneumonia are aspiration events. Depending on the colonization of the oropharynx and the volume of aspirate material plays a role in the development of subsequent disease. It stands to reason that, if we are able to figure out what is colonizing the oropharynx, we may be able

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Creep? The Implications of Rising MICs for Vancomycin in Staphylococcus Aureus

Look, I know I have talked a lot about staphylococcus but there is a ton of details that go into the therapeutic aspects of it.  When it comes to staphylococcus aureus bacteremia, specifically MRSA, vancomycin is the first line therapy per the IDSA guidelines (1). I have discussed the issues with vancomycin dosing, and how

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Echo? Who, what, when, how? Role of echo modality in Staph aureus bacteremia.

I absolutely love this song. I tried to learn how to play it on guitar, but I think you may need 7 strings for it, at least when I checked back in the day. This week we are adding to last week’s topic and talking about when and what type of echo to get. There

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Infective Endocarditis: A Journey Through Definitions

At any rate, at approximately one-quarter to twelve that night, I remember distinctly getting up from my chair and from the table, where my books lay, and taking off my suit coat. No sooner had I removed the left arm of my coat, than there was on the ventral aspect of my left wrist a

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The Lyon Heart – The Virulent Coagulase-Negative Staphylococcus

Coagulase negative staphylococcus are generally skin commensals we tend to ignore when they pop up in one set of blood cultures as they tend to represent contamination of the blood culture bottles rather than true bacteremia. The most commonly seen is Staphylococcus epidermidis. The reason they are called “coagulase negative staphylococcus” is these organisms, compared

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Weekly Articles: Week of 11/15/2020

Morgan DJ, Zhan M, Goto M, Franciscus C, Alexander B, Vaughan-Sarrazin M, Roghmann MC, Pineles L. The Effectiveness of Contact Precautions on Methicillin-Resistant Staphylococcus aureus in Long-term Care Across the United States. Clin Infect Dis. 2020 Oct 23;71(7):1676-1683. doi: 10.1093/cid/ciz1045. PMID: 31637429. This was a cohort study of long-term VA facilities (aka the CLC) evaluating

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MRSA Pneumonia Coverage – The Shorr Score

Empiric therapy for patients with pneumonia is not as clear cut as one would think. Guidelines tend to differ in terms of when to start empiric MRSA coverage, with some guidelines recommending initial therapy that covers MRSA in those who are admitted to the ICU (1), while other guidelines suggest to start MRSA therapy if

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