Morbidity, mortality, and management of methicillin-resistant S. aureus bacteremia in the USA: update on antibacterial choices and understanding

ABSTRACT

Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is associated with significant healthcare costs, morbidity, and mortality in the United States. Complications of MRSA bacteremia include infective endocarditis, osteomyelitis, and sepsis, all of which are difficult to treat. Time to effective therapy and antibacterial choice greatly affect patient outcomes. Vancomycin and daptomycin remain first-line therapies; however, reports of vancomycin-associated treatment failure and reduced daptomycin susceptibility highlight the need to define alternative strategies for MRSA bacteremia treatment. In addition, several patient- and pathogen-specific factors influence the outcomes of MRSA bacteremia. It is, therefore, critical to explore the interaction between host- and pathogen-specific factors and its effect on MRSA bacteremia pathogenesis and mortality. This review discusses the factors that drive the development of MRSA bacteremia and examines alternative treatment strategies.

KEYWORDS:

• Bacteremia
• Staphylococcus aureus
• methicillin-resistant S. aureus
• vancomycin
• daptomycin
• telavancin
• dalbavancin
• oritavancin
• linezolid
• ceftaroline

Acknowledgments

Editorial support was provided by Tanmayi Mankame, PhD; and Nicole Seneca, PhD, of AlphaBioCom, LLC, King of Prussia, Pennsylvania, USA, and was funded by Theravance Biopharma R&D, Inc.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have received an honorarium from PGM for their review work, but have no other relevant financial relationships to disclose.

Additional information

Funding

Theravance Biopharma R&D, Inc., provided funding for editorial support. The authors did not receive payment for development or publication of this manuscript.