Morbidity, mortality, and management of methicillin-resistant S. aureus bacteremia in the USA: update on antibacterial choices and understanding

Hosp Pract (1995). 2018 Apr;46(2):64-72. doi: 10.1080/21548331.2018.1435128. Epub 2018 Feb 12.

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is associated with significant healthcare costs, morbidity, and mortality in the United States. Complications of MRSA bacteremia include infective endocarditis, osteomyelitis, and sepsis, all of which are difficult to treat. Time to effective therapy and antibacterial choice greatly affect patient outcomes. Vancomycin and daptomycin remain first-line therapies; however, reports of vancomycin-associated treatment failure and reduced daptomycin susceptibility highlight the need to define alternative strategies for MRSA bacteremia treatment. In addition, several patient- and pathogen-specific factors influence the outcomes of MRSA bacteremia. It is, therefore, critical to explore the interaction between host- and pathogen-specific factors and its effect on MRSA bacteremia pathogenesis and mortality. This review discusses the factors that drive the development of MRSA bacteremia and examines alternative treatment strategies.

Keywords: Bacteremia; Staphylococcus aureus; ceftaroline; dalbavancin; daptomycin; linezolid; methicillin-resistant S. aureus; oritavancin; telavancin; vancomycin.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / economics
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteremia / drug therapy*
  • Bacteremia / economics
  • Daptomycin / therapeutic use
  • Health Care Costs
  • Humans
  • Methicillin-Resistant Staphylococcus aureus*
  • United States
  • Vancomycin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Vancomycin
  • Daptomycin