aureus: repulsion of peptidoglycan-targeted antibodies.

ibitory and bactericidal titers to assess the adequacy of antibiotic therapy are often recommended for osteomyelitis and endocarditis (,). Peak and trough bactericidal titers of at least 1:64 and 1:32, respectively, were suggested as good predictors of a successful therapeutic outcome in patients with infective endocarditis (). However, the serum bactericidal titer (SBT) is subject to variation and lack of reproducibility with staphylococci (,). The serum test does not predict efficacy in animal models of endocarditis (,). Clinically, the test lacks precision in predicting outcome or bacteriological failure (, ,,). Clinical response and results of follow-up blood cultures remain the best indicators of clinical outcome. Re-analysis of data from two large multicenter studies showed that outcome was strongly correlated with trough titers of SBTs (, ). This supports the concept that the efficacy of beta-lactams depends on the time above the MIC, as most patients in these studies received beta-lactams as their principal therapy (). Currently, it is not possible to define the optimal trough titer for a successful outcome.

aureus infections are caused by MRSA strains.

T1 - A model of the complex response of Staphylococcus aureus to methicillin

aureus in simulated endocardial vegetations.

The definitive diagnosis of disease is made by isolation and identification of the species of Staphylococcus. Depending in the conditions being investigated, samples of sputum, purulent material, blood and urine should be obtained. Several sets of blood cultures are required to make a diagnosis of S. aureus septicemia or endocarditis. Echocardiography, especially transesophageal, is crucial for confirming the diagnosis of endocarditis.

aureus bacteremia/endocarditis trial [see Clinical Trials (14.2)].

equisimilis, and Enterococcus faecalis (vancomycin-susceptible isolates only).

Staphylococcus aureus Bloodstream Infections (Bacteremia), Including Those with Right-Sided Infective Endocarditis, Caused by Methicillin-Susceptible and Methicillin-Resistant Isolates

Limitations of Use
.

CUBICIN is not indicated for the treatment of left-sided infective endocarditis due to S.

aureus (MRSA) strains, that are a major cause of soft skin and tissue infections and bacteremia.
aureus) is a Gram-positive bacterial pathogen that has emerged as a major public health threat.

Teichoic Acid Cross Linking Staphylococcus Aureus - …

Green tea administered as a spray has been successfully used in the treatment of an MRSA infection of the trachea (windpipe). Unfortunately, epicatechin gallate cannot by widely administered because it is broken down by esterases in the body to the inactive products, epicatechin and gallic acid. This prevents the oral or parenteral co-administration of ECG with oxacillin or methicillin. Recently, two other polyphenolic compounds, corilagin, extracted from the leaves of Arctostaphylos uva-ursi and tellimagrandin I extracted from the petals of rose red (Rosa canina L.) have been reported. Both compounds act synergistically with oxacillin. Corilagin appears to interfere with PBP2a activity rather than PBP2a synthesis and has greater activity against MRSA than either ECG or tellimagrandin I. Further investigations into the mechanisms of action of these polyphenolic compounds combined with the synthesis of more stable derivatives are warranted.

Acid Cross Linking Staphylococcus Aureus.

Peptidoglycan synthesis is a complex process involving the coordination of both biosynthetic and degradative pathways. PBP2a is not native to S. aureus, and has to fit within this system. Unfortunately, PBP2a is less sensitive to the action of methicillin and is capable of conferring methicillin resistance. Fortunately, the substrate requirements of PBP2a are relatively strict and this is a weakness that can be exploited. By targeting and inhibiting the proteins, such as FemA and FemB, involved the formation of these substrates, methicillin resistance can be modulated. Compounds such as epicatechin gallate and corilagin are attractive compounds to develop into therapeutic agents since these compounds exist already and are known to modulate methicillin resistance.

a mediator of staphylococcus aureus response to cell wall damage.

Macrolide-resistant isolates of these organisms should be screened for clindamycin inducible resistance using the D-zone test.

Clindamycin has been shown to be active against most of the isolates of the following microorganisms, both in vitro and in clinical infections, as described in the INDICATIONS AND USAGE section.

Gram-positive Aerobes
Staphylococcus aureus (methicillin-susceptible strains)
Streptococcus pneumoniae (penicillin-susceptible strains)
Streptococcus pyogenes

Anaerobes
Prevotella melaninogenica
Fusobacterium necrophorum
Fusobacterium nucleatum
Peptostreptococcus anaerobius
Clostridium perfringens

At least 90% of the microorganisms listed below exhibit in vitro minimum inhibitory concentrations (MICs) less than or equal to the clindamycin susceptible MIC breakpoint for organisms of a similar type.