MRSA Diagnosis & Treatment Delayed

Reuters Health reports that MRSA infections which are spreading in hospitals are not being recognized or treated as promptly as it should.

“NEW YORK (Reuters Health) – Even with early therapy, infection-related mortality from nosocomial bacteremic Staphylococcus aureus pneumonia (NBSAP) is high, according to a report in the September issue of Chest. [Nosocomial is a fancy word for “acquired in the hospital.”]

“Patients with methicillin-resistant S. aureus (MRSA) pneumonia are at high risk to receive initial inadequate therapy,” Dr. Peggy S. McKinnon from Barnes-Jewish Hospital in St. Louis, Missouri told Reuters Health. “Early recognition of MRSA as an important pathogen is essential.”

Reuters Health reports that MRSA infections, which are spreading in hospitals, are not being recognized or treated as promptly as they should.

“NEW YORK (Reuters Health) – Even with early therapy, infection-related mortality from nosocomial bacteremic Staphylococcus aureus pneumonia (NBSAP) is high, according to a report in the September issue of Chest. [Nosocomial is a fancy word for “acquired in the hospital.”]

“Patients with methicillin-resistant S. aureus (MRSA) pneumonia are at high risk to receive initial inadequate therapy,” Dr. Peggy S. McKinnon from Barnes-Jewish Hospital in St. Louis, Missouri told Reuters Health. “Early recognition of MRSA as an important pathogen is essential.”

Dr. McKinnon and colleagues evaluated the epidemiology, treatment, and outcomes of NBSAP in 60 patients treated from 1999 through early 2004 at a level-1 trauma center. Forty-two patients (70%) were infected with MRSA.

Clinical and microbiological success rates were between 50% and 57%, the investigators report, and 33 patients (55.5%) died during the hospitalization — most of them (24 patients, 40%) due to NBSAP.

Fewer patients with MRSA than with methicillin-sensitive S. aureus (MSSA) infection received appropriate therapy within the first 2 days of hospitalization (50% versus 72.2%, respectively), the report indicates, but overall clinical and microbiological success rates did not differ between patients with MRSA and those with MSSA.

Primary outcomes did not differ between patients who received delayed versus early appropriate antibiotic therapy, the researchers note. No treatment time breakpoint produced an increased probability of infection-related mortality.

The investigators describe this finding as the most surprising outcome from the study.

“These findings suggest that newer agents with enhanced clinical activity in NBSAP are needed and that these should be evaluated in a real-world setting, where outcomes of the sickest patients can be assessed,” the authors conclude….

“The emergence of this superbug along with concerns for the future appearance of avian influenza, potentially further increasing outbreaks of MRSA pneumonia, makes this an important health-care concern for the community as well as the hospital setting,” the editorialists conclude.

Chest 2005;128:1414-1422,1093-1095.”