Methicillin resistant Staphylococcus aureus in the critically ill

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Presentation transcript:

Methicillin resistant Staphylococcus aureus in the critically ill K.J. Hardy, P.M. Hawkey, F Gao, B.A. Oppenheim British Journal of Anaesthesia Volume 92, Issue 1, Pages 121-130 (January 2004) DOI: 10.1093/bja/aeh008 Copyright © 2004 British Journal of Anaesthesia Terms and Conditions

Fig 1 The introduction of antibiotics and consequent evolution of resistance in S. aureus. British Journal of Anaesthesia 2004 92, 121-130DOI: (10.1093/bja/aeh008) Copyright © 2004 British Journal of Anaesthesia Terms and Conditions

Fig 2 Action of β-lactam antibiotics on the peptidoglycan structure of the bacterial cell wall. (a) Cleavage of the peptide side chain releases the energy needed by transpeptidases to form the cross links of the peptidoglycan lattice. (b) Formation of the stable structure of the peptidoglycan lattice. (c) β-Lactams inactivate the PBPs and prevent the cleavage of the peptide side chain, and therefore prevent the release of energy and consequently cross linking. Results in a structure, which is lethal for cell growth. British Journal of Anaesthesia 2004 92, 121-130DOI: (10.1093/bja/aeh008) Copyright © 2004 British Journal of Anaesthesia Terms and Conditions

Fig 3 Staphylococcus aureus bacteraemia laboratory reports and methicillin susceptibility for England and Wales, 1992–2001. (Courtesy of Public Health Laboratory Service.) British Journal of Anaesthesia 2004 92, 121-130DOI: (10.1093/bja/aeh008) Copyright © 2004 British Journal of Anaesthesia Terms and Conditions

Fig 4 MRSA acquisition and transmission between ICU, the hospital and the community. Patients are admitted to ICU colonized with MRSA, but a larger percentage of patients are transferred from ICU back to the general wards colonized with MRSA. This pattern is then continued out into the community. British Journal of Anaesthesia 2004 92, 121-130DOI: (10.1093/bja/aeh008) Copyright © 2004 British Journal of Anaesthesia Terms and Conditions

Fig 5 MRSA screening protocol on the Intensive Care Unit. British Journal of Anaesthesia 2004 92, 121-130DOI: (10.1093/bja/aeh008) Copyright © 2004 British Journal of Anaesthesia Terms and Conditions