Week 9 - Topic 2: MDRO - Gram Positive Flashcards
What are 2 gram + MDROs?
Methicillin resistant Staphylococcus aureus (MRSA)
Vancomycin resistant Enterococcus (VRE)
What genes and protein does MRSA have?
mecA gene
PBP2a –> protein binding penicillin 2a
How do you call MRSA in French?
SARO (oxacillin resistant)
What genes does VRE have?
Van A, Van B or Van2/3 genes
Where do you usually find Staph aureus?
Upper respiratory tract and skin
Where do you usually find enterococcus?
GI tract (intestine), mouth, vagina
When were AMR bacteria discovered?
1960s: penicillin resistant S aureus
1980s: MRSA
1990s: CA-MRSA
mid 1990s: VRE
2002: VRSA (vancomycin resistant S aureus)
Where can CA-MRSA (community acquired) be found?
Contact sports Tattoo/body piercing facilities Daycares, prisons, military recruits, hurricane shelters Gyms Pets and animals
What are the characteristics of CA-MRSA?
- Majority have Panton-Valentine leukocidin (PVL) cytotoxin
- Cause leukocyte destruction and tissue necrosis
- Increase virulence
- Sensitive to clina/erthyromycin
What are the characteristics of HA-MRSA?
- Mec A gene
- Resistant to Clinda/Erthyromycin
What are 3 symptoms of CA-MRSA
1) Necrotic lesions on skin/mucosa
2) Clusters of abscesses or “spider bites”
3) Necrotic hemorrhagic pneumonia
What are the 2 VRE found in feces?
Enterococcus faecium
Enterococcus facalis
What is the treatment for VRE Enterococcus facium?
Linezolid (oxazolidinones class)
Keep in mind that it suppresses bone marrow and blood cell counts should be done weekly!
What is the treatment for MRSA when vancomycin fails?
Daptomycin
When is Synercid (Quinupristin/dalfopristin) used?
Staph aureus or VRE Enterococcus facium
