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Printable Handouts
Navigable Slide Index
- Introduction
- Financial disclosure
- Clinical features of CA-MRSA
- CA-MRSA pneumonia vs. MRSA in HCAP patient
- When is empiric MRSA therapy needed?
- CT scan of CA-MRSA patient on admission
- PVL positive S. aureus pneumonia
- Conclusions about CA-MRSA pneumonia therapy
- The role of serum PCT in sepsis
- PCT reduces duration of infection therapy
- PCT-guides de-escalation: PRORATA study
- PCT guidance of therapy duration in Dutch ICUs
- PCT guidance and reduced mortality
- Meta-analysis of steroids for CAP
- Steroids in severe CAP to reduce treatment failure
- Steroids and COVID-19
- Meta-analysis of steroids for influenza
- Adjunctive IgM enhanced immunoglobulin
- Risk factors for MDR pathogens
- PES pathogens
- Prediction of MDR pathogens in CAP
- Treatment of P. aeruginosa
- A simplified and unified algorithm for all patients
- Outcomes when the algorithm wasn't followed
- Severe aspiration pneumonia recommendations
- New antibiotics for severe CAP/PES pathogens
- Key points
- Thank you
Topics Covered
- Community-acquired MRSA
- CA-MRSA pneumonia therapy
- Serum procalcitonin
- Steroids in severe CAP and COVID-19
- Multidrug resistant pathogens
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Niederman, M.S. (2022, May 31). New concepts in the management of CAP: a focus on severe illness - MRSA and MDR pathogens [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved October 7, 2024, from https://doi.org/10.69645/TSDJ1697.Export Citation (RIS)
Publication History
Financial Disclosures
- Professor Niederman has been a consultant for Bayer, AbbVie, Pfizer, Gilead, Merck, Nabriva and N8 Medical. He has also received research grants from Bayer, Merck and Shionogi.
New concepts in the management of CAP: a focus on severe illness - MRSA and MDR pathogens
Published on May 31, 2022
24 min
Other Talks in the Series: Periodic Reports: Advances in Clinical Interventions and Research Platforms
Transcript
Please wait while the transcript is being prepared...
0:05
I've listed here my
financial disclosures,
which include my consulting
arrangements with a number
of pharmaceutical companies
and research grants.
These are disclosures
that could be
potentially relevant to
the presentation today.
0:19
Let's talk about
community-acquired MRSA,
a pathogen that can occur in
community-acquired pneumonia,
but one that we need to have
a high level of suspicion about,
not necessarily treating
empirically in everybody,
but certainly thinking about
in those individuals who
have serious illness with
necrotizing pneumonia.
Generally, community-acquired
MRSA is not like nosocomial MRSA
and can occur in previously
healthy individuals.
The clinical features that suggest
that a patient is at risk for
community-acquired
MRSA includes:
cavitary pneumonia,
rapidly increasing
pleural effusion,
coughing up blood and
recent influenza in an individual
who was previously healthy.
Probably even more so than those who've
been vaccinated for pneumococcus,
where pneumococcus
would be less likely.
These are all things to
think about as risk factors
for community-acquired MRSA.
1:14
Community-acquired
MRSA, as I pointed out,
is not the same as
nosocomial MRSA.
Community-acquired MRSA
is a clonal illness.
It's commonly associated
with the pathogens
associated with
exotoxin production,
particularly the USA300
strain that produces
the Panton-Valentine
leukocidin, the PVL toxin.
It's that toxin
production that is so bad
for patients with
community-acquired MRSA.
It's the toxin
that is associated
with the necrotizing infection.
These individuals generally
have a higher degree of
antibiotic susceptibility
than those with nosocomial MRSA.
Nosocomial MRSA is not generally
associated with
toxin production,
and is generally not
associated with susceptibility
to clindamycin and
trimethoprim sulfa,
which is the case in
community-acquired MRSA.
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