MRSA bacteraemia

Methicillin-resistant Staphylococcus aureus (MRSA) has been pandemic for over a decade and is causing a major increase in serious staphylococcal infections. This is reflected in large increases in S. aureus bacteraemia with over 50% in many countries being caused by MRSA. Moreover, in some countries it also seems as though methicillin-susceptible S. aureus (MSSA) bacteraemia is also increasing. MRSA certainly has not replaced MSSA but is an additional burden with significantly higher mortality. Standard treatment of MRSA bacteraemia with glycopeptides is probably suboptimal in the presence of increasing resistance, MIC drift, uncertainties about laboratory susceptibility testing and fears of toxicity. New antibiotics look set to replace glycopeptides as the gold standard for treatment of MRSA bacteraemia, but whether the underlying causes of MRSA bacteraemia can be addressed successfully in order to control this pandemic disease is less certain. (C) 2007 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.