tetracycline and Pneumonia--Staphylococcal

Topics: Chlamydia Infections; Chlamydophila psittaci; Humans; Meningococcal Infections; Mycoplasma Infections; Penicillins; Pneumonia; Pneumonia, Pneumococcal; Pneumonia, Staphylococcal; Pneumonia, Viral; Tetracycline

Topics: Adolescent; Adult; Aminosalicylic Acids; Bronchitis; Child; Child, Preschool; Erythromycin; Female; Haemophilus Infections; Herpesviridae Infections; Humans; Infant; Isoniazid; Male; Mycoplasma Infections; Penicillins; Pneumococcal Infections; Pneumonia; Pneumonia, Pneumocystis; Pneumonia, Staphylococcal; Pneumonia, Viral; Radiography; Respiratory Tract Infections; Skin Tests; Streptococcal Infections; Tetracycline; Tuberculosis, Pulmonary

The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in cystic fibrosis (CF) patients in the United States is approximately 25%. Little is known about the relative proportion of hospital- versus community-associated strains or the antimicrobial susceptibility of MRSA in different CF centers. We hypothesized that the majority of MRSA isolates obtained from children with CF are those endemic in the hospital and that those associated with community acquisition (SCCmec IV) would be more resistant than typically seen in non-CF MRSA isolates.. We studied MRSA strains from seven pediatric CF centers to determine the clonal distribution based on DNA sequencing of the staphylococcal protein A gene (spa typing), the type of staphylococcal chromosomal cassette mec (SCCmec), and the proportion of strains with Panton-Valentine leukocidin (PVL). Antimicrobial susceptibility to systemic and topical antibiotics was compared between different MRSA types.. We analyzed 277 MRSA isolates from unique patients (mean age 11.15 ± 4.77 years, 55% male). Seventy % of isolates were SCCmec II PVL negative and the remainder SCCmec IV. Overall 17% MRSA strains were PVL positive (all SCCmec IV). Spa typing of 118 isolates showed most of the SCCmec II strains being t002, while SCCmec IV PVL positive isolates were t008, and SCCmec IV PVL negative isolates represented a variety of spa-types. The proportions of SCCmec II strains and spa-types were similar among centers. Overall rates of resistance to trimethoprim-sulfamethoxazole (4%), tetracycline (7%), tigecycline (0.4%), linezolid (0.4%) as well as fosfomycin (0.4%), fusidic acid (3%), and mupirocin (1%) were low. No strains were resistant to vancomycin. SCCmec II strains had higher rates of resistance to ciprofloxacin and clindamycin (P < 0.001) than SCCmec IV strains.. In this U.S. study, most MRSA isolates in the pediatric CF population were SCCmec II PVL negative. Rates of resistance were low, including to older and orally available antibiotics such as trimethoprim-sulfamethoxazole.

Topics: Acetamides; Adolescent; Anti-Bacterial Agents; Bacterial Proteins; Bacterial Toxins; Bronchoscopy; Child; Child, Preschool; Cohort Studies; Cystic Fibrosis; DNA, Bacterial; Exotoxins; Female; Fosfomycin; Fusidic Acid; Humans; Leukocidins; Linezolid; Male; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Minocycline; Molecular Typing; Mupirocin; Oxazolidinones; Penicillin-Binding Proteins; Pharynx; Pneumonia, Staphylococcal; Sequence Analysis, DNA; Sputum; Staphylococcal Infections; Staphylococcal Protein A; Tetracycline; Tigecycline; Trimethoprim, Sulfamethoxazole Drug Combination; United States

Persistent bronchopleural fistulas (BPF) due to infection, trauma, or thoracic surgical procedures are often difficult to manage. We report a patient with fulminant Staphylococcus aureus pneumonia complicated by chronic BPF formation which prevented weaning from mechanical ventilation due to severe air leak. Fistula closure was obtained by instillation of tetracycline into the fistula via a fiberoptic bronchoscope using a balloon catheter and blood clot occlusion technique. This closed the BPF and allowed successful weaning from mechanical ventilation.

Topics: Adolescent; Bronchial Fistula; Bronchoscopy; Fistula; Humans; Instillation, Drug; Male; Pleural Diseases; Pneumonia, Staphylococcal; Sclerotherapy; Tetracycline

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Child; Child, Preschool; Humans; Infant; Meningitis, Pneumococcal; Middle Aged; Penicillin G; Penicillin Resistance; Pneumococcal Infections; Pneumonia, Staphylococcal; Respiratory Tract Infections; Streptococcus pneumoniae; Sulfonamides; Tetracycline

Topics: Acute Disease; Aminophylline; Anti-Bacterial Agents; Blood Coagulation; Body Temperature; Chronic Disease; Erythromycin; Furosemide; Heparin; Humans; Nikethamide; Nystatin; Oleandomycin; Penicillins; Peptide Hydrolases; Physical Therapy Modalities; Plasma Substitutes; Pneumonia; Pneumonia, Staphylococcal; Streptomycin; Strophanthins; Sulfadimethoxine; Sulfanilamides; Tetracycline; Vitamins

Topics: Administration, Oral; Adult; Aged; Alanine Transaminase; Aspartate Aminotransferases; Asthma; Bronchiectasis; Bronchitis; Female; Humans; Lung Abscess; Male; Middle Aged; Pneumonia, Staphylococcal; Respiratory Tract Infections; Tetracycline; Tuberculosis, Pulmonary

Topics: Ampicillin; Anti-Bacterial Agents; Bacteria; Bronchiectasis; Bronchitis; Cephaloridine; Chloramphenicol; Chronic Disease; Cloxacillin; Erythromycin; Humans; Lactose; Methicillin; Oxytetracycline; Penicillin G; Penicillin Resistance; Pneumonia; Pneumonia, Staphylococcal; Pneumonia, Viral; Streptomycin; Tetracycline

Topics: Anti-Bacterial Agents; Child; Child, Preschool; Erythromycin; Furunculosis; Glycosides; Humans; Impetigo; Infant; Lincomycin; Male; Microbial Sensitivity Tests; Penicillin Resistance; Penicillins; Pneumonia, Staphylococcal; Pyrrolidines; Staphylococcal Infections; Staphylococcus; Tetracycline

Topics: Aged; Ampicillin; Bronchiectasis; Diabetes Complications; Erythromycin; Humans; Lung; Male; Oxacillin; Pneumonia, Staphylococcal; Radiography; Sputum; Staphylococcus; Tetracycline; Virulence

Topics: Adult; Anti-Bacterial Agents; Carrier State; Child; Chloramphenicol; Chlortetracycline; Colistin; Erythromycin; Erythromycin Ethylsuccinate; Humans; Oxytetracycline; Penicillin Resistance; Penicillins; Pneumonia, Staphylococcal; Russia; Staphylococcal Infections; Staphylococcus; Streptomycin; Tetracycline

Topics: Drainage; Empyema; Female; Humans; Infant; Lung Abscess; Male; Penicillins; Pleuropneumonia; Pneumonia, Staphylococcal; Pneumothorax; Tetracycline

Topics: Abscess; Anti-Bacterial Agents; Bacitracin; Bronchial Fistula; Chloramphenicol; Empyema; Erythromycin; Humans; Kanamycin; Novobiocin; Penicillins; Pleural Effusion; Pneumonia; Pneumonia, Staphylococcal; Pneumothorax; Sepsis; Staphylococcal Infections; Tetracycline; Vancomycin

Topics: Adolescent; Aerosols; Anti-Bacterial Agents; Candidiasis; Child; Chloramphenicol; Drug Therapy; Erythromycin; Follow-Up Studies; Humans; Infant; Kanamycin; Leukopenia; Methicillin; Neomycin; Novobiocin; Oxygen Inhalation Therapy; Penicillins; Pneumonia; Pneumonia, Staphylococcal; Radiography, Thoracic; Staphylococcal Infections; Tetracycline; Toxicology

Topics: Aerosols; Anti-Bacterial Agents; Humans; Lung Abscess; Oxygen Inhalation Therapy; Pneumonia; Pneumonia, Staphylococcal; Pregnancy; Respiration, Artificial; Staphylococcal Infections; Tetracycline