Staphylococcus Aureus Bacteraemia in the Lao People’s Democratic Republic: Antibiotic Susceptibility Patterns and Clinical Management
- VernacularTitle:້ຊືມເຊື້ອເລືອດຍ້ອນເຊື້ອ STAPHYLOCOCCUS AUREUS (SB) ໃນ ສປປ ລາວ: ການຕອບສະໜອງຂອງເຊື້ອຕໍ່ຢາຕ້ານເຊື້ອ ແລະ ການປິ່ນປົວ
- Author:
Ivo Elliott
;
Koukeo Phommasone
;
Manivanh Vongsouvath
;
David Dance
;
Rattanaphone Phetsouvanh
- Publication Type:Review
- Keywords:
Staphylococcus aureus;
bacteraemia;
antibiotic susceptibility;
MRSA;
Laos
- From:
Lao Medical Journal
2012;non(3):3-15
- CountryLao People's Democratic Republic
- Language:Lao
-
Abstract:
Staphylococcus aureus is a common and often serious human pathogen accounting for about a fifth of all
cases of bacteraemia with an associated mortality of up to 50%. This review summarizes the aspects of S. aureus
bacteraemia that are relevant in a Lao context, including the antibiotic susceptibility patterns seen at Mahosot
Hospital, Vientiane over the past 11 years and provides guidance and rationale for clinical management. In the
Lao PDR it is the third commonest cause of bacteraemia and the leading cause of skin and soft-tissue infection.
Mahosot Hospital has seen almost 200 cases and antibiotic susceptibility testing shows that a significant
proportion of isolates are tetracycline and erythromycin resistant. Methicillin-resistance remains very rare,
though this is unlikely to continue. Key risk factors for S. aureus disease in financially-poor settings include
surgical procedures and previous antibiotic exposure. The identification and removal or drainage of a focus of
infection is a key part of the management strategy. Transthoracic echocardiography (TTE) is advised for all
patients, where this technique is accessible, and consideration should be given to repeating this test or
performing a transoesophageal echocardiogram for patients with a negative TTE, but with a high index of
suspicion for infective endocarditis. Treatment with a !-lactam antibiotic (preferably cloxacillin), for 2 weeks in
uncomplicated disease and 4 to 6 weeks in complicated disease, is essential to provide cure and prevent relapse.
An oral switch may be required, though this should take place only if the patient has been afebrile for 48 hours
and has no ongoing complications requiring intervention.
Copyright: ∀ 2012 Elliot et al. This is an open-access article distributed under the terms of the Creative
Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium,
provided the original author and source are credited.
