Although first identified just 14 decades ago, methicillin-resistant Staphylococcus aureus (MRSA) has undergone rapid evolutionary changes and epidemiologic expansion to become a major cause of nosocomial and com-munity-acquired infections worldwide. Increasing resistance to vancomycin among MRSA strains in con-junction with availability of new antibiotics, including daptomycin and linezolid, have increased treatment choices but made clinical treatment decisions more challenging. This article describes the clinical features and management issues of 2 challenging-to-treat manifestations of MRSA infection, bacteremia and/or endocarditis and osteomyelitis. It also presents a brief review of community-associated MRSA infections and preventive strategies directed against MRSA. Micrococcus, which, when limited in extent and activity, causes acute suppurative inflammation (phlegmon), produces, when more extensive and intense in its action on the human system, the most virulent forms of septicaemia and pyaemia, as well as many forms intermediate be-tween the two extremes. Alexander Ogston, on the organism now known as S. aureus [1] Staphylococcus aureus is a commensal bacterium that

The aim of this study was to evaluate the combination of daptomycin and fosfomycin in experimental chronic implant-associ-ated osteomyelitis due to methicillin-resistant Staphylococcus aureus (MRSA). Infection was induced in the tibiae of rats by the insertion of a bacterial inoculum (1 to 5 108 CFU/ml) of a clinical MRSA isolate and a titaniumwire. Four weeks after infec-tion, each animal was assigned to a treatment group: daptomycin monotherapy at 60 mg/kg of body weight once daily (n 10), fosfomycin monotherapy at 40 mg/kg once daily (n 10), or daptomycin and fosfomycin combined at 60 mg/kg and 40mg/kg, respectively, once daily (n 9). Ten animals were left untreated. After a 3-week treatment period, the animals were euthanized, and the infected tibiae and implants were processed for quantitative bacterial cultures. The bacterial cultures from bones were positive for MRSA in all animals in the untreated group, the daptomycin group, and the fosfomycin group, with median bacterial counts of 2.34 106 CFU/g bone, 1.57 106 CFU/g bone, and 3.48 102 CFU/g bone, respectively. In the daptomycin-fosfomy-cin group, 6 out of 9 animals were positive for MRSA, with a median count of 7.92 CFU/g bone. Bacterial cultures derived from the titaniumwires were negative in the fosfomycin- and daptomycin-fosfomycin-treated groups. Based on bacterial counts in bones, treatment with daptomycin-fosfomycin was statistically significantly superior to all that of the other groups (P< 0.003). Fosfomycin was superior to daptomycin and no treatment (P< 0.0001). No development of resistance was observed in any treat-ment arm. The combination of daptomycin and fosfomycin demonstrated synergism against MRSA in experimental implant-associated osteomyelitis.

High correlation of scotopic and photopic electroretinogram components with severity of central retinal artery occlusion

License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Daptomycin is a lipopeptide antibiotic with a unique mechanism of action on Gram-positive bacteria. It is approved for treatment of skin and soft-tissue infections with Gram-positive bacteria, bacteraemia and right-sided infective endocarditis caused by Staphylococcus aureus. Diminishing susceptibility of S. aureus to daptomycin during treatment of complicated infections and clinical failure have been described. Combinations of daptomycin with other antibiotics including gentamicin, rifampin, betalactams, trimethoprim/sulfamethoxazole (TMP-SMX), or clarithromycin present a new approach for therapy. In vitro and animal studies have shown that such combinations may, in some cases, be superior to daptomycin monotherapy. In this paper we focus on the antibiotic combinations for complicated S. aureus infections. 1.

vitro activity of daptomycin and vancomycin lock solutions on

Comparative efficacy of daptomycin and vancomycin in the therapy of