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admin | What Treats Bv | 09.10.2013
An important part of treatment is providing patient education about good wound care, taking all antibiotics as prescribed, and the need for follow-up visits, if necessary.
To celebrate Stem Cell Awareness Day this year, we’ll take a look at stem cell-related stories that have been covered by the Biology Bytes blog.
Induced pluripotent stem cells (iPSCs) have enormous potential for being used in tissue transplants and therapies. This image shows the retina of a person with intermediate age-related macular degeneration, an eye disease recently treated with iPSCs for the first time. Even though human iPSCs were first created in late 2007, it wasn’t until last week that they were used in a tissue transplant in a human for the first time.
The Lost Ladybug Project is a citizen science project that has people find ladybugs and send in their pictures (along with details) to help researchers better understand ladybug populations. Previously, Biology Bytes explored citizen biology projects that people can do from the comfort of their own home computer.
Last summer, the small Glowing Plant company raised nearly $500,000 (much more than their goal of $65,000) through Kickstarter to make the glowing plants, and it has been working on creating these plants since then. With the ALS ice bucket challenge going viral, amyotrophic lateral sclerosis (ALS) has been getting a lot of attention. Just last Thursday, three papers were published in The New England Journal of Medicine that came to very different conclusions about how much table salt (sodium chloride) we should have in our diets if we want to avoid cardiovascular disease and a related death.
First we’ll explore the papers that might make you less afraid of shaking a few dashes of salt onto your next meal.
We have a long history with the silkworm (Bombyx mori), which was native throughout Asia and thought to have been domesticated more than 5,000 years ago in China to make silk. Ebola has been in the headlines a lot lately, mostly because the current outbreak is the largest one we’ve ever seen. When a person becomes infected by the Ebola virus, it can take 2 to 21 days before they show symptoms (although it’s typically 8 to 10 days).
The yellow fever mosquito (Aedes aegypti) is one of the two mosquito species that can transmit the chikungunya virus. Luckily, the infection is not usually fatal, but can be extremely painful and debilitating. Last week, we took a look at the amazing diversity of microbes (bacteria, fungi, and others) that live on, and inside of, our bodies. Shown here are Lactobacillus bacteria (the dark-colored rods) in a vaginal smear (the large pink shapes are human cells). These bacteria (Staphylococcus epidermidis) are commonly found on dry, flat areas of the skin, playing an important role in the skin microbiome.
Here we’ll do a survey of what’s known about the various microbiomes than live on, and inside of, our bodies, while next time we’ll dig deeper into how these microscopic communities may be connected to our health.
You may have heard the news that the Earth’s magnetic field (also called the geomagnetic field) is changing. Some of the first studies of animals using the Earth’s magnetic field to navigate were done using homing pigeons, like this one here. A new study may not only make you want to head to bed on time tonight, but also try to make sure you don’t get any interruptions during the night. While the volunteers in the recent study were women in their 20s, we can all appreciate getting some uninterrupted sleep. Specifically, this study found that having one interrupted night of sleep (8 hours in a bed but with four interruptions, where each interruption needed a 15-minute, purposeful response) is just as bad as having a night with only 4 hours of sleep. Last week, the Supreme Court ruled that, due to religious objections, Hobby Lobby (and other for-profit companies) does not have to provide health insurance coverage for contraceptives that are part of the Affordable Care Act. Despite Hobby Lobby’s owners’ beliefs, scientific evidence shows that these contraceptives don’t actually cause abortions.
Electroencephalography (EEG) recordings are done (as shown here) to measure what type of brain waves a person’s brain is making. Typically, when a person has dreams, they are in the “rapid eye movement” (REM) phase of their sleep (so-called because their eyes really do rapidly, and randomly, move around). While Jupiter’s moon Europa (shown here) is covered in ice, it contains a liquid ocean underneath that may be home to tiny life forms. This computation method takes into account several factors that affect whether life can survive on a planet. In the past six months, several interesting and promising studies have been published on Alzheimer’s disease.
Eating a healthy diet including lots of vegetables and fruits may help decrease a person’s risk of getting Alzheimer’s.
Certain bacteria species (like the Pseudomonas aeruginosa shown here in brown) may be involved in triggering heart attacks and strokes.
Researchers examined plaques in the arteries of 15 patients with advanced atherosclerosis and found that at least 10 species of bacteria lived closely with the plaques.
As we become more aware of the resources that we’re quickly using up, we increasingly look for ways to recycle and reuse what we’ve got.
Researchers have been taking leftover baked goods and turning them into key ingredients for making biodegradable plastic. The biodegradable plastic, which is specifically polybutylene succinate (PBS), is made using a chemical called succinic acid.
The researchers found that after a person drinks green tea, DNA damage in their cells decreased, which has obvious implications for people wanting to eat certain foods to stay healthy. In January, two papers were published in the prestigious journal Nature showing how to make stem cells using a shockingly simple and completely novel approach — by putting cells in an acid bath.
Because they help us fight bacterial infections, antibiotics are an amazing invention that has let us greatly improve our quality of life and life expectancy. Taken with a high-magnification (scanning electron) microscope, this picture shows several methicillin-resistant Staphylococcus aureus (MRSA) bacteria (yellow) and a dead human white blood cell (red, specifically a neutrophil).
This drawing shows how an oligodendrocyte protects part of a neuron (in red) with a myelin sheath.
Very unfortunately, the trial became stalled in late 2011, mostly due to financial concerns (but it did undoubtedly help pave the way for other hESC-based clinical trials to get FDA approval starting in 2010). Since it was first discovered in a person in mid-2012, MERS (short for Middle East respiratory syndrome) has been a looming viral threat.
This is a high-magnification image of the MERS coronavirus (created using a transmission electron microscope). The first people infected with MERS-CoV were in Saudi Arabia, and still all known cases of MERS-CoV infections can be traced back to Saudi Arabia and the surrounding countries on the Arabian Peninsula. Note: The Biology Bytes blog will only be updated on Tuesday this week (the author is traveling in Japan).
A microscope set up at the Miraikan Museum in Tokyo that allows visitors to look at retinal cells derived from stem cells.
Miraikan has many exhibits that clearly were created because they highlight a cutting-edge, key scientific idea, and do so in a way that really engages visitors.
Note: The Biology Bytes blog will only be updated on Tuesdays during this week and next week. Have you ever wondered why it’s so hard to remember things from when you were a little kid, before the age of 3 or so?
This microscope image shows neurons in a mouse brain, specifically pyramidal neurons in the brain’s cortex (the neurons were made to produce a green fluorescent protein so they are easier to see).
Toxoplasma gondii, a parasite (primarily passed on through cats and undercooked meat) that makes mice unafraid of cat urine and people have slower reaction times and other, more subtle, changes. The bacteria Clostridium difficile is pretty terrifying — if it infects a person’s gut, it can cause severe diarrhea, bloating, and potentially death. Antibiotic-resistant Clostridium difficile, the bacteria shown here (taken from a stool sample), has been identified as an “urgent” threat by the Centers for Disease Control and Prevention in a recent report. With Mother’s Day coming up, it can be fun to talk about some of our family’s genetic traits, like eye color, hair color, or having mid-digit hair (yup, that’s genetic too!). A model of DNA that has been epigenetically modified (specifically by methylation, represented by the bright circles). While our genetics are a collection of our genes (together making up our genome), epigenetics are certain factors that control which genes we’re using.
Doing citizen science really helps researchers who have collected more data than they can feasibly analyze on their own. Treatment options for community-associated MRSA differ from those of health care-associated MRSA.
Infectious illness due to community-associated methicillin-resistant Staphylococcus aureus is increasingly being addressed in the medical news media. Patients frequently suspect a "spider bite." The involved site is red, swollen, and painful and may have pus or other drainage. It’s a day to celebrate stem cells, have discussions on what stem cell research is, and learn about potential benefits and disease treatments using stem cells. Specifically, we’ll check out some of this last year’s big stem cell news, trending stem cell-related issues in social media, exciting discoveries, and how to bring stem cell science to the K-12 classroom. The person was a Japanese woman in her 70s, and the iPSC-derived cells were used to treat her age-related macular degeneration (AMD), a leading cause of blindness in the elderly. The main species of plant being used is Arabidopsis thaliana, which is a small flowering plant that belongs to the mustard family. Several lawmakers have chosen to participate in the challenge even though they previously significantly cut funding for research into the disease. These two papers are a part of the large-scale PURE (Prospective Urban and Rural Epideimological) Study — they basically show that high levels of sodium may not necessarily be harmful unless you are in a certain high-risk group, and that the relationship between eating salt and increasing blood pressure levels is not linear.
Silkworms today are biological silk-producing machines, the products of thousands of years of careful breeding. There have also been people transported into the United States who were infected, raising concerns about an Ebola outbreak happening in the country.


The virus (pronounced chik-en-gun-ye) was discovered in 1952 in Africa, and has been slowly making its way around the world… although the pace has been quickened in recent years. The virus, which is spread by certain mosquitos from person to person, primarily causes a fever and joint pains in 4 to 7 days after being bitten, but other symptoms include headaches, joint swelling, muscle aches, and rashes. This week we’ll dig deeper into our microbiomes and explore what’s known about how they help keep us healthy, and why they sometimes make us sick.
An abundance of Lactobacillus bacteria in a vagina has been long thought to be necessary for having a healthy vagina, but it turns out this isn’t always the case. This is because this kind of switch is thought to actually happen a lot (speaking in geological times) — it last happened about 800,000 years ago, and we haven’t found any mass extinctions related to the event. This was measured by testing cognitive abilities and attention spans the next day through an activity online, as well as self-reporting moods. Instead, they primarily work by preventing fertilization, which happens before a woman is even technically pregnant. Lucid dreams can be quite fun and freeing — they are when the dreamer realizes that they are in a dream, and can control the dream to be what they want it to be. And while dreams occur during the REM phase, different parts of the brain can be active depending on the type of dream. It’s a question we’ve been trying to actively answer for decades now, with increased interest in more recent times. They’ve ranged from how what we eat might affect our odds of developing it, to discovering the underlying mechanisms. For example, some people have been figuring out how to “reuse” food waste by turning it into plastic. Succinic acid can be produced using various types of chemical reactions, from different source materials. For example, while drinking tea is thought to possibly help reduce the risk of a number of diseases and health conditions, many studies have had inconsistent results, and the chemical mechanisms that go on in our bodies are not well understood. At the same time, an enzyme that’s involved in the DNA-repairing process became much more active.
The resultant mouse stem cells were called STAP cells (for stimulus-triggered acquisition of pluripotency).
However, their overuse has led to some extremely dangerous pathogens — antibiotic-resistant bacteria.
In spinal cord injuries, oligodendrocytes die in large numbers and can no longer protect the neurons with myelin, often resulting in paralysis. At that point, Geron stated that they’d withdraw from the stem cell field entirely — in early 2013, Geron’s hESC-related assets, including the FDA-approved clinical trial, were bought by another company, BioTime Inc. MERS is a disease caused a type of virus called a coronavirus (CoV), which typically infects the respiratory and gastrointestinal systems. It’s now thought that the virus came from camels in Saudi Arabia, as camels have been found carrying similar viruses and can be infected with MERS-CoV, but details on any specific cases of transmission between people and camels are unknown. It’s fascinating not only to learn scientific concepts from them, but also to see what specific topics and interactive activities have been chosen to be turned into exhibits; the exhibits are the end result of a careful selection process (due to limited space and resources).
Here I’ll explore some of the current biology-related exhibits that were surely made with these criteria in mind.
Next week will feature a special tidbit on biology-related exhibits at the Miraikan National Museum of Emerging Science and Innovation in Tokyo, Japan, which the author will be visiting.
It’s largely done by creating new neurons (which are specialized cells that send signals and are made through a process called neurogenesis).
It was found that infection with the parasite not only affects our behavior (which is not too surprising considering the effect of infection on mice), but also our immune response, which has far-reaching consequences, such as potentially changing which embryos are selected by a woman’s body for pregnancy. And according to two recent studies, because of epigenetics, what your mother ate before you were even conceived, and whether your father had a stressful childhood or not, may affect who you are today. Or maybe you are a scientist and would like to aid others in doing more investigations in your spare time. This month’s Pharmacology Consult column will review the use of antibiotics in the treatment of infection with this pathogen, including their role and selection, in the pediatric population. What is MRSA?MRSA is a kind of Staphylococcus aureus ("staph") bacterium that is resistant to beta-lactam antibiotics, including methicillin, oxacillin, penicillin and amoxicillin. Staph infections also can cause more serious infections, such as blood stream infections or pneumonia; with symptoms of shortness of breath, fever, and chills.
How are MRSA infections treated?Like other staph infections, many MRSA infections are best treated with good wound and skin care: keeping the area clean and dry, washing hands after caring for the area, carefully disposing of any bandages, and allowing the body to heal. A high-morbidity outbreak of methicillin-resistant Staphylococcus aureus among players on a college football team, facilitated by cosmetic body shaving and turf burns.
Many national and international events (especially in California) are taking place to celebrate this special day — the California Institute for Regenerative Medicine (CIRM) has a webpage summarizing these stem cell events.
It’s because iPSCs can be made using virtually any cells from a person’s body — such as skin or fat samples that wouldn’t be missed. Safety studies in mice and monkeys had been previously done to ensure the iPSCs would not cause tumors or be rejected by the immune system. However you enjoy taking in the natural world around you, there may be a way you can help scientists with important research at the same time! These inspiring, sustainability-focused ideas were what the Glowing Plant Project used to raise public support in creating plants that glow.
It’s clearly a controversial topic that draws a lot of interest because it potentially affects so many people. Silk production is now a multi-billion dollar industry, with around 150,000 tons of silk created every year. This is accomplished by changing the genetics of the silkworms so that they make modified silk, or medical proteins, instead of their ordinary silk. Researchers have since then identified five subspecies of the Ebola virus, four of which cause the Ebola disease in humans (the fifth causes it in nonhuman primates). The idea is that by understanding which microbes are beneficial and help keep us healthy, we could develop ways to promote the growth of such microbes (and figure out how to deter populations of pathogenic, or disease-causing, microbes).
The geomagnetic poles may in fact switch, with the North becoming the South and vice versa. It turns out that not getting enough sleep can be just as detrimental as repeatedly getting woken up at night. Overall, awoken and sleep-restricted volunteers similarly omitted more answers and made more mistakes when doing the activity, and reported more depression and fatigue, compared to when getting a night with a solid 8 hours of uninterrupted sleep.
Specifically, in lucid dreams, areas of the brain that are associated with higher cognitive function are active, but these areas are inactive during non-lucid dreams. The distance of the planet from its central star is also essential and affects the planet’s temperature. Based on a study published earlier this month, a key player may actually be some specific species of bacteria. It turns out that some are making biofilms, which are clumps of bacteria that harmoniously grow together to cover a surface. And not just any type of plastic — it’s actually biodegradable plastic, which makes the exchange even more exciting and desirable. Succinic acid has typically been petroleum-based, but recently people have been working on making bio-based succinic acid.
However, since then, other researchers have had great difficulty making their own STAP cells following the procedures in the papers, and there have been accusations of misconduct, specifically falsification and fabrication of data. Centers for Disease Control and Prevention (CDC) identified MRSA as being among 12 microorganisms that have a “serious” threat level.
The clinical trial, undertaken by the Geron Corporation, was for using hESCs to treat patients with spinal cord injuries and paralysis. While in people the virus appears to only be spread through close contact, it still continues to spread, crossing country boundaries, and leading to the first two known cases in the U.S. Last week, I had the pleasure of visiting Miraikan, the National Museum of Emerging Science and Innovation in Tokyo, Japan. If you’re a biology fan (or just enjoy learning more science in general) and will be visiting the Tokyo area any time soon, you’ll want to be sure to drop by Miraikan to check them out (along with the other incredible exhibits)! While it’s been thought that neurogenesis is the basis for memory, a study published earlier this month shows that instead of creating memories, neurogenesis may actually cause people to forget them. These traits might seem unrelated, but they actually can be due to the same thing — infection by a very common parasite called Toxoplasma gondii (which infects people through exposure to cats and eating undercooked meat). Whatever your background, there are actually many ways that you can now do real scientific research in your spare time, most of them from your own home computer.
Read on to find out about some that you could get involved with to start doing real science at home on your computer!
It is often resistant to many other antibiotics as well.For general information about MRSA and Staphylococcus aureus for patients, please see the resource list below. Sometimes staph skin infections may be treated by incision and drainage, depending on severity. And not just simply glow — the plants would ideally produce as much light as light bulbs.
And most people with ALS (90% of them) have no family history with the disease — why they get ALS is unclear. An outbreak usually happens when people come in contact with infected wild animals (typically fruit bats [a highly suspected reservoir], rodents, pigs, or primates), and then the virus is transmitted from person-to-person. Symptoms can progress to nausea, vomiting, diarrhea, and chest and abdominal pain, and then to jaundice (yellow skin), confusion, bleeding (hemorrhaging), severe weight loss, and organ failure. This sounds simple enough in theory, but in reality things get a bit complicated — it can be difficult to know which are the “good” microbes and which are the “bad” ones (especially since this sometimes varies from person to person).
Read on to find out about some of the many critters that use Earth’s magnetic field to figure out their location and how to navigate to a different location. It turns out that it just needs the right kind of electrical stimulation, and the dreamer is off to be the commander of their dream world.


The recent study found that, during REM, when some of these inactive areas are stimulated with the right electrical signal (having a certain frequency), they become active and induce lucid dreams.
Based on our understanding of the spectrum of organisms that live on Earth and the conditions that life needs to thrive, we can hypothesize what other life-bearing planets may look like. For those of us who have watched older family members mentally decline due to the devastating effects of this genetic disease, these studies may help give some hope that the same fate does not await us. After a great deal of controversy, the lead author, Haruko Obokata, announced last week, on June 4, that she agreed to retract both articles.
Impressively, a single dose of Oritavancin can effectively fight a MRSA infection (while most antibiotics, if they can be used against MRSA at all, require multiple days of treatment). Not only does this helps explain the phenomenon of childhood amnesia, but it has other fascinating implications as well. A little while ago we talked about the Toxoplasma parasite, how it’s thought that about one in three people in the U.S.
Why is MRSA a problem for healthcare providers?In Massachusetts and elsewhere throughout the country, MRSA infections are becoming more common.Identifying a MRSA infection can be difficult because the symptoms of MRSA infection are similar to those of other skin infections. Antibiotic treatment, if indicated, should be guided by the susceptibility patterns of the organism in the setting or area. Four pediatric deaths from community-acquired methicillin-resistant Staphylococcus aureus - Minnesota and North Dakota, 1997-1999.
This means that if a patient needs a certain type of retinal cell to treat an eye disease, a skin sample could be taken, turned into the desired retinal cells, and then transplanted into the patient’s eye.
They’re essentially forced to incorporate a glowing gene (taken from glowing bacteria) into their own genes. Ebola usually kills 50% to 90% of infected people (although the current epidemic has about a 55% to 60% fatality rate). Read on to find out what’s known about our microscopic neighbors, both the good and the bad. Using this basic approach, a newly developed computation method estimates that there may be more than 100 million planets in our Milky Way galaxy that could be home to complex life. A single-dose treatment like this should clearly cut down on the time that a patient with an antibiotic-resistant infection spends in a hospital, which is where antibiotic-resistant microorganisms can easily spread to vulnerable patients and cause serious (and ongoing) problems. While this is a relatively low number of infected individuals, MERS-CoV continues to spread — it’s now been found in 12 different countries, recently including the United States.
Analyzing the data can range from categorizing pictures of distant galaxies to playing a game where you get points for solving the structure of a protein, and so much more in between. Infection in people has been typically considered asymptomatic, but it turns out that this isn’t really the case — surprisingly, and concerningly, studies are showing that infection can affect human development, immune response, personality, and much more. Risk factors for community associated methicillin-resistant Staphylococcus aureus infections in an outbreak of disease among military trainees in San Diego, California, in 2002. For this reason it is important that healthcare providers diagnose MRSA early and accurately, prescribe appropriate antibiotics if needed, and direct patients to complete the full course of antibiotics as prescribed. Emergence and spread of community associated methicillin-resistant Staphylococcus aureus in rural Wisconsin , 1989 to 1999. At the same time, healthcare providers should be cautious about the unnecessary use of antibiotics, which can contribute to the problem of antibiotic resistance. What is the history of MRSA and Antibiotic Resistance?Not long after penicillin was in wide use, it was recognized that some staphylococci were less sensitive to penicillin than other staphylococci. As early as the mid-1940s, Alexander Fleming, the British scientist who is often credited with the discovery of penicillin, warned health care workers about overuse and misuse of antibiotics as a contributor to the development of antibiotic resistance.MRSA was first discovered several decades ago in hospitals and other healthcare settings across the country.
Infection with MRSA presented in the form of surgical wound infections, urinary tract infections, bloodstream infections and pneumonia.In recent years, MRSA infections are being diagnosed with increased frequency in people who have had no contact with healthcare facilities and are otherwise healthy. Are there different types of MRSA infections?In the past, the term "Healthcare-Associated MRSA" (HA-MRSA) has been used to describe MRSA infections acquired in healthcare settings. External LinksFor more information about MRSA, visit:Los Angeles County Department of Health Services.
The term "Community-Associated MRSA" (CA-MRSA) has been used to describe MRSA infections that occur in the community in people who have not had contact with a healthcare setting.There are genetic differences between HA-MRSA and CA-MRSA, which may result in differing susceptibility to certain antibiotics. However, both HA-MRSA and CA-MRSA infections have the same symptoms, and are controlled and prevented in the same manner. Given the rise in CA-MRSA infections, the distinction in terms is no longer considered to be as important as it once was. Who is at increased risk for getting MRSA infections in the community?Outbreaks of illness due to MRSA are seen most commonly among particular populations: inmates in correctional facilities (1), athletes participating in team sports (2), neonates (3), military recruits (4), and Native Americans and Pacific Islanders (5,6), among others. Bell, PharmD, BCPS Genotype differencesGenotypes of CA-MRSA strains are distinct from HA-MRSA isolates.
When comparing patients with CA-MRSA to those with HA-MRSA, a study in Minnesota showed that CA-MRSA patients were more likely to be non-white, younger and have lower median income.
The mecA gene is transported on a mobile genetic element known as a staphylococcal cassette chromosome (SCC). Are my patients at higher risk for MRSA infection?MRSA infections sometimes occur among previously healthy persons with no identifiable risk factors.
Interim Guidelines for Evaluation and Management of Community- Associated Methicillin-Resistant Staphylococcus Aureus Skin and Soft Tissue Infections in Outpatient Settings. However, identifying patients at increased risk for MRSA can guide empiric antibiotic selection and avoid use of agents ineffective against MRSA (particularly cephalosporins). These genes are associated with resistance to multiple drug classes, in addition to beta-lactam antibiotics.
SCCmec types IV and V encode for resistance to beta-lactam antibiotics and are found primarily in CA-MRSA isolates.
Another important characteristic differentiating CA-MRSA strains from HA-MRSA strains is the production of unique toxins and virulence factors. Analyses have revealed differing genes and toxins isolated from CA-MRSA strains that have not been found in HA-MRSA isolates. Case reports of previously healthy children and adults affected with CA-MRSA infection and the resulting necrotic clinical manifestations, which have been fatal in some cases, have been published. Although the true prevalence of PVL toxin production in CA-MRSA is not known, some reports indicate that the majority of CA-MRSA isolates are able to secrete this highly potent toxin. The most common CA-MRSA clone circulating in the United States, USA300, carries the genes encoding PVL.
However, the USA 300 CA-MRSA clone is being increasing recognized as a nosocomial pathogen and so the molecular characteristics of CA-MRSA and HA-MRSA strains are becoming blurred. Documentation of the effectiveness of TMP-SMX comes from case reports and anecdotal recommendations.
Sensitivity studies documenting the susceptibility of CA-MRSA to TMP-SMX should be obtained with its use.
Because TMP-SMX contains a sulfonamide antibiotic, it should not be used in children with a history of a documented true allergic reaction to previous sulfonamide use. As CA-MRSA infection may also occur in newborns, caution should be used when prescribing TMP-SMX in these patients.
As TMP-SMX may displace bilirubin from albumin binding sites, this antibiotic should not be used in newborns with increased bilirubin. Because TMP-SMX does not provide adequate activity toward group A streptococcus, it should not be used if this pathogen is suspected (eg, infection associated with lymphangitis, concomitant streptococcal pharyngitis, erysipelas) or is grown upon culture. Resistance may develop rapidly with clindamycin use, despite an initial sensitivity report indicating that the MRSA isolate is susceptible. Most, if not all, microbiology laboratories can utilize the disk diffusion method (D-zone test) to test for inducible macrolide-lincosamide-streptogramin B (MLSB) resistance. Clindamycin should not be used if the D-test is positive, which indicates inducible resistance.
Clindamycin is a viable option for infants aged younger than 2 months with CA-MRSA infection. Parenthetically, many pharmacies are able to flavor liquid medication products with commercially available flavoring systems.
Although MRSA is usually sensitive to vancomycin, strains with intermediate susceptibility, or, more rarely, resistant strains have been reported. Incision and drainage is helpful, and it may be sufficient alone without antibiotics in mild cases. In children with mild-moderate illness (eg, febrile, systemic symptoms), it is appropriate to add systemic antibiotic therapy. However, if local or regional CA-MRSA susceptibility data indicate that resistance to clindamycin is greater than 15%, it has been recommended to avoid using clindamycin empirically.
Some evidence suggests that therapy with linezolid or clindamycin may be beneficial in PVL-positive CA-MRSA infection. Consideration may be given to adding rifampin or gentamicin to vancomycin for serious illness.
When using vancomycin empirically, it is appropriate to initially prescribe nafcillin or oxacillin additionally, as these agents provide more rapid bactericidal action toward methicillin-susceptible Staphylococcus aureus.
Nasal application of mupirocin may be beneficial in some patients to prevent recurrence of infection.
Bell, PharmD, BCPS, is a Professor of Pharmacy Practice at Drake University College of Pharmacy and a Clinical Specialist at Blank Children’s Hospital, Des Moines, Iowa.
Management and outcome of children with skin and soft tissue abscesses caused by community-acquired methicillin-resistant Staphylococcus aureus. Pleuropulmonary complications of Panton-Valentine leukocidin-positive community-acquired methicillin-resistant Staphylococcus aureus.



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