About: Vancomycin Monotherapy May Be Insufficient to Treat Methicillin-resistant Staphylococcus aureus Coinfection in Children With Influenza-related Critical Illness

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About: Vancomycin Monotherapy May Be Insufficient to Treat Methicillin-resistant Staphylococcus aureus Coinfection in Children With Influenza-related Critical Illness Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Vancomycin Monotherapy May Be Insufficient to Treat Methicillin-resistant Staphylococcus aureus Coinfection in Children With Influenza-related Critical Illness
Creator	Cvijanovich, Natalie Markovitz, Barry Novak, Tanya Xu, Ruifei Randolph, Adrienne Thomas, Neal Weiss, Scott Ackerman, Kate Gedeit, Rainer Giuliano, John Hall, Mark Hartman, Mary Moffitt, Kristin Newhams, Margaret Sanders, Ronald Shein, Steven Tarquinio, Keiko Truemper, Edward Wardenburg, Juliane
source	Medline; PMC
abstract	BACKGROUND: Coinfection with influenza virus and methicillin-resistant Staphylococcus aureus (MRSA) causes life-threatening necrotizing pneumonia in children. Sporadic incidence precludes evaluation of antimicrobial efficacy. We assessed the clinical characteristics and outcomes of critically ill children with influenza–MRSA pneumonia and evaluated antibiotic use. METHODS: We enrolled children (<18 years) with influenza infection and respiratory failure across 34 pediatric intensive care units 11/2008–5/2016. We compared baseline characteristics, clinical courses, and therapies in children with MRSA coinfection, non-MRSA bacterial coinfection, and no bacterial coinfection. RESULTS: We enrolled 170 children (127 influenza A, 43 influenza B). Children with influenza–MRSA pneumonia (N = 30, 87% previously healthy) were older than those with non-MRSA (N = 61) or no (N = 79) bacterial coinfections. Influenza–MRSA was associated with increased leukopenia, acute lung injury, vasopressor use, extracorporeal life support, and mortality than either group (P ≤ .0001). Influenza-related mortality was 40% with MRSA compared to 4.3% without (relative risk [RR], 9.3; 95% confidence interval [CI], 3.8–22.9). Of 29/30 children with MRSA who received vancomycin within the first 24 hours of hospitalization, mortality was 12.5% (N = 2/16) if treatment also included a second anti-MRSA antibiotic compared to 69.2% (N = 9/13) with vancomycin monotherapy (RR, 5.5; 95% CI, 1.4, 21.3; P = .003). Vancomycin dosing did not influence initial trough levels; 78% were <10 µg/mL. CONCLUSIONS: Influenza–MRSA coinfection is associated with high fatality in critically ill children. These data support early addition of a second anti-MRSA antibiotic to vancomycin in suspected severe cases.
has issue date	2018-06-09(xsd:dateTime)
bibo:doi	10.1093/cid/ciy495
bibo:pmid	29893805
has license	bronze-oa
sha1sum (hex)	0a2c35d762e771909b1dc494e960075a0671d76f
schema:url	https://doi.org/10.1093/cid/ciy495
resource representing a document's title	Vancomycin Monotherapy May Be Insufficient to Treat Methicillin-resistant Staphylococcus aureus Coinfection in Children With Influenza-related Critical Illness
has PubMed Central identifier	PMC6336914
has PubMed identifier	29893805
schema:publication	Clinical Infectious Diseases
resource representing a document's body	covid:0a2c35d762e771909b1dc494e960075a0671d76f#body_text
is schema:about of	named entity 'INFECTIOUS DISEASES' named entity 'antimicrobial' named entity 'Investigator' named entity 'EVALUATION' named entity 'ANTIMICROBIAL' named entity 'EFFICACY' named entity 'INVESTIGATORS' named entity 'PEDIATRIC' named entity 'METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS' named entity 'CRITICAL ILLNESS' named entity 'VANCOMYCIN' named entity 'MAY BE' covid:arg/0a2c35d762e771909b1dc494e960075a0671d76f named entity '27S' named entity 'INSUFFICIENT' named entity 'INVESTIGATOR' named entity 'COINFECTION' named entity 'CHILDREN' named entity 'CLINICAL' named entity 'RELATED' named entity 'SEPSIS' named entity 'INFLUENZA' named entity 'PEDIATRIC INTENSIVE CARE' named entity 'INFLUENZA' named entity 'ACUTE LUNG INJURY' named entity 'TREAT' named entity 'CHILDREN' named entity 'ANTIBIOTIC USE' named entity 'MRSA PNEUMONIA' named entity 'MONOTHERAPY' named entity 'NETWORK' named entity 'OUTCOMES' named entity 'STAPHYLOCOCCUS AUREUS' named entity 'CRITICALLY ILL CHILDREN' named entity 'ASSESSED' named entity 'NECROTIZING PNEUMONIA' named entity 'INCIDENCE' named entity 'CLINICAL CHARACTERISTICS' named entity 'CAUSES' named entity 'LIFE' named entity 'SPORADIC' named entity 'antibiotic' named entity 'necrotizing pneumonia' named entity 'evaluated' named entity 'Injury' named entity 'necrotizing pneumonia' named entity 'MRSA' named entity 'Staphylococcus aureus' named entity 'antibiotic' named entity 'influenza' named entity 'Intensive Care' named entity 'Sepsis' named entity 'critically ill' named entity 'vasopressor' named entity 'Infectious Diseases' named entity 'cytokines' named entity 'coinfection' named entity 'symptom' named entity 'coinfected' named entity 'Influenza' named entity 'Influenza' named entity 'acute renal failure' named entity 'vancomycin'

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