Pneumonia Due to Methicilin-Resistant Staphylococcus aureus (MRSA): A Review

Garyphallia      Poulakou; Jessica      Souto; Nina      Kmet Lunacek; Jordi      Rello

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as an important nosocomial pathogen in recent decades, being responsible for an increasing proportion of patients with Hospital-Acquired Pneumonia (HAP) and Ventilator-Associated Pneumonia (VAP). On the other hand, many areas in the world have experienced an alarming emergence of infections and particularly pneumonias caused by the so-called Community-Acquired MRSA (CA-MRSA), a genetically distinct strain, which shares common clinical and microbiological features with nosocomial MRSA. This paper reviews the latest epidemiological and therapeutic data and discusses currently available and future treatment options. A recent significant epidemiological feature is the “creep” observed in vancomycin minimal inhibitory concentrations. As new clinical and PK data are available relating to the use of vancomycin and linezolid, which have both been first-line options in the treatment of MRSA pneumonia in the last decade, recently issued guidelines and arguments for their revision are discussed.

Keywords: Antimicrobials, CA-MRSA, linezolid, MRSA, pneumonia, vancomycin, pathogen, Hospital-Acquired Pneumonia, Ventilator-Associated Pneumonia, mecA gene