ABSTRACT
This meeting focused on infections in humans and animals due to methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase (ESBL)-producing bacteria and Clostridium difficile, and their corresponding treatments. MRSA is predominantly a human pathogen, and molecular typing has revealed that certain clones have spread widely both between humans and from humans to animals. ESBL-producing bacteria, particularly those that express the CTX-M beta-lactamases, have been disseminated worldwide. Whilst such strains are usually isolated from humans, some animal isolates also produce CTX-M enzymes. In humans, one clone of CTX-M-producing Escherichia coli, sequence type (ST)131, has been particularly successful. C. difficile, often ribotype 027, commonly colonizes the hospital environment and causes serious infections in humans. In animals, ribotype 078 is more often found, and is an important cause of diarrhoea in piglets. There is a concern that the numbers of MRSA or other antimicrobial-resistant bacteria might increase further when human isolates become established in animals, as this can amplify the numbers of such bacteria by dissemination within animal groups with subsequent spread back to humans. Certain antimicrobials have been implicated in the selection of MRSA, ESBL-producing bacteria and predisposition to infection by C. difficile. Guidelines for treatment and prevention of infections by MRSA, ESBL-producing bacteria and C. difficile were discussed and evidence-based policies were recommended for both humans and animals.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Bacterial Infections/microbiology , Bacterial Infections/veterinary , Drug Resistance, Bacterial , Drug Utilization , Prescriptions/statistics & numerical data , Animals , Bacterial Infections/drug therapy , Bacterial Typing Techniques , Clostridioides difficile/classification , Clostridioides difficile/drug effects , Clostridioides difficile/isolation & purification , Clostridium Infections/drug therapy , Clostridium Infections/microbiology , Enterobacteriaceae Infections/drug therapy , Enterobacteriaceae Infections/microbiology , Escherichia coli/classification , Escherichia coli/drug effects , Escherichia coli/isolation & purification , Health Policy , Humans , Methicillin-Resistant Staphylococcus aureus/classification , Methicillin-Resistant Staphylococcus aureus/drug effects , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Molecular Epidemiology , Staphylococcal Infections/drug therapy , Staphylococcal Infections/microbiology , beta-Lactamases/biosynthesisABSTRACT
These evidence-based guidelines are an updated version of those published in 2006. They have been produced after a literature review of the treatment and prophylaxis of methicillin-resistant Staphylococcus aureus (MRSA). The guidelines aim to complement those recently published for the antibiotic treatment of common and emerging community-onset MRSA infections in the UK. The guidelines have reviewed and updated, where appropriate, previous recommendations, taking into account any changes in the UK epidemiology of MRSA, ongoing national surveillance data and the value of new antistaphylococcal agents licensed for use in UK practice. Emerging therapies that have not been licensed for UK use are not reviewed, but their future potential role has been mentioned where deemed appropriate. Recommendations are given for the treatment of common infections caused by MRSA, elimination of MRSA from carriage sites and prophylaxis of surgical site infection.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Carrier State/drug therapy , Carrier State/prevention & control , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Staphylococcal Infections/drug therapy , Staphylococcal Infections/prevention & control , Antibiotic Prophylaxis/methods , Carrier State/epidemiology , Carrier State/microbiology , Humans , Staphylococcal Infections/epidemiology , Staphylococcal Infections/microbiology , United Kingdom/epidemiologyABSTRACT
These evidence-based guidelines have been produced after a literature review of the treatment and prophylaxis of methicillin-resistant Staphylococcus aureus (MRSA) infection. The guidelines were further informed by antibiotic susceptibility data on MRSA from the UK. Recommendations are given for the treatment of common infections caused by MRSA, elimination of MRSA from carriage sites and prophylaxis of surgical site infection. There are several antibiotics currently available that are suitable for use in the management of this problem and potentially useful new agents are continuing to emerge.