Management of methicillin-resistant staphylococcus aureus bloodstream infections: a comprehensive narrative review of available evidence focusing on current controversies and the challenges ahead DOI
Alberto Enrico Maraolo, Milo Gatti, Luigi Principe

et al.

Expert Review of Anti-infective Therapy, Journal Year: 2025, Volume and Issue: unknown

Published: March 31, 2025

Bloodstream infections (BSIs) caused by Staphylococcus aureus are common worldwide, representing one of the most relevant issues in clinical infectious diseases practice. In particular, BSIs methicillin-resistant S. (MRSA-BSI) still today a challenge since mortality burden remains elevated although decades research. The following topics regarding MRSA-BSI were reviewed and discussed resorting to best available evidence retrieved from PubMed/MEDLINE up October 2024: i) epidemiology; ii) microbiology; iii) classification, with focus on complicated not forms; iv) structured approach patient; v) pharmacokinetics pharmacodynamics main antimicrobial options; vi) controversies therapeutic approach. Despite ongoing efforts better stratify manage MRSA-BSI, there is no universally accepted classification system accurately distinguishing between uncomplicated/low risk complicated/high forms. Biomarkers such as interleukin(IL)-10 hold promise order enable more precise stratification, premise for an appropriate treatment plan. There theoretical rationale implementing combination therapy including beta-lactam agent upfront, especially patients considered at higher unfavorable outcomes, but further data necessary, same applies newer adjuvants. Novel microbiological techniques may help guiding duration.

Language: Английский

Management of methicillin-resistant staphylococcus aureus bloodstream infections: a comprehensive narrative review of available evidence focusing on current controversies and the challenges ahead DOI
Alberto Enrico Maraolo, Milo Gatti, Luigi Principe

et al.

Expert Review of Anti-infective Therapy, Journal Year: 2025, Volume and Issue: unknown

Published: March 31, 2025

Bloodstream infections (BSIs) caused by Staphylococcus aureus are common worldwide, representing one of the most relevant issues in clinical infectious diseases practice. In particular, BSIs methicillin-resistant S. (MRSA-BSI) still today a challenge since mortality burden remains elevated although decades research. The following topics regarding MRSA-BSI were reviewed and discussed resorting to best available evidence retrieved from PubMed/MEDLINE up October 2024: i) epidemiology; ii) microbiology; iii) classification, with focus on complicated not forms; iv) structured approach patient; v) pharmacokinetics pharmacodynamics main antimicrobial options; vi) controversies therapeutic approach. Despite ongoing efforts better stratify manage MRSA-BSI, there is no universally accepted classification system accurately distinguishing between uncomplicated/low risk complicated/high forms. Biomarkers such as interleukin(IL)-10 hold promise order enable more precise stratification, premise for an appropriate treatment plan. There theoretical rationale implementing combination therapy including beta-lactam agent upfront, especially patients considered at higher unfavorable outcomes, but further data necessary, same applies newer adjuvants. Novel microbiological techniques may help guiding duration.

Language: Английский

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