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      Recovery of a 10-year-old girl from methicillin-resistant Staphylococcus aureus sepsis in response to low-dose ceftaroline treatment

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          Abstract

          A 9-year-old girl was severely injured in a car accident in Afghanistan, in which both her lower legs were badly damaged. She was treated at the Hospital of Ingolstadt (Klinikum Ingolstadt) after she had undergone initial surgery at an Indian hospital. Various bacterial species were isolated from multiple wounds, and methicillin-resistant Staphylococcus aureus (MRSA) was one among them. After the amputation of her lower legs, she developed MRSA sepsis, which was successfully treated with a relatively low dosage of ceftaroline (Zinforo ®/Teflaro ®; 2×9 mg/kg/d), although the bacterial isolate’s minimal inhibitory concentration (1.5–4 mg/L) suggested a decreased susceptibility. In summary, ceftaroline was highly efficient and well tolerated by the patient suffering from MRSA sepsis.

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          Most cited references 14

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          spa Typing of Staphylococcus aureus as a frontline tool in epidemiological typing.

          We determined the value of spa typing in combination with BURP (based upon repeat pattern) grouping analysis as a frontline tool in the epidemiological typing of Staphylococcus aureus, based on a random collection of 1,459 clinical isolates sent to the German Reference Centre for Staphylococci within a 6-month period. The application was found to be helpful for the classification of isolates into the particular clonal lineages currently prevalent in Germany. Due to its major advantages because of the ease of interpretation and the exchangeability of the results, the use of spa typing greatly simplifies communication between laboratories on both the national and the international levels. Thus, it is an excellent tool for national and international surveillance of S. aureus as well as for analysis of the short-term local epidemiology. However, to overcome the limitations of the BURP grouping method in terms of typing accuracy and discriminatory power, the results of the default BURP grouping method must be interpreted with caution. Additional markers, like staphylococcal chromosomal cassette mec, lineage-specific genes, or alternative DNA polymorphisms, are indispensable. They should be selected by dependence on the clonal lineage indicated by spa typing and subsequent BURP analysis as well as on the basis of the particular question to be addressed.
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            Staphylococcus aureus screening and decolonization in orthopaedic surgery and reduction of surgical site infections.

            Staphylococcus aureus is the most common organism responsible for orthopaedic surgical site infections (SSIs). Patients who are carriers for methicillin-sensitive S. aureus or methicillin-resistant S. aureus (MRSA) have a higher likelihood of having invasive S. aureus infections. Although some have advocated screening for S. aureus and decolonizing it is unclear whether these efforts reduce SSIs.
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              • Record: found
              • Abstract: found
              • Article: not found

              High incidence of discontinuations due to adverse events in patients treated with ceftaroline.

              To determine clinical outcomes in patients who received ceftaroline (Teflaro) 600 mg intravenously every 8 or 12 hours after failing or developing intolerance to first-line agents including vancomycin, daptomycin, or linezolid.
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                Author and article information

                Journal
                Ther Clin Risk Manag
                Ther Clin Risk Manag
                Therapeutics and Clinical Risk Management
                Therapeutics and Clinical Risk Management
                Dove Medical Press
                1176-6336
                1178-203X
                2016
                11 May 2016
                : 12
                : 749-753
                Affiliations
                [1 ]Department of Infectious Diseases and Infection Control, Klinikum Ingolstadt, Ingolstadt, Germany
                [2 ]Department of Anaesthesiology and Intensive Care Medicine, Klinikum Ingolstadt, Ingolstadt, Germany
                [3 ]Department of Trauma Surgery, Klinikum Ingolstadt, Ingolstadt, Germany
                [4 ]National Reference Centre for Staphylococci and Enterococci, Division Nosocomial Pathogens and Antibiotic Resistances, Department for Infectious Diseases, Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany
                Author notes
                Correspondence: Stefan Borgmann, Department of Infectious Diseases and Infection Control, Klinikum Ingolstadt, Krumenauer Str. 25, D-85049 Ingolstadt, Germany, Tel +49 841 880 2020, Fax +49 841 880 2849, Email stefan.borgmann@ 123456klinikum-ingolstadt.de
                Article
                tcrm-12-749
                10.2147/TCRM.S99987
                4868870
                27274260
                © 2016 Borgmann et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Categories
                Case Report

                Medicine

                side effects, susceptibility, ceftaroline, minimal inhibitory concentration, therapy

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