Meeting the Challenge of New Infectious Scourges: MRSA, C difficile BI/NAP1, and New Strains of STD Pathogens

Within the past decade, the incidence of methicillin-resistant Staphylococcus aureus (MRSA) has increased significantly, spreading from the hospital to the community setting. Patients with skin infections whose condition is stable should be treated with antibiotic therapy as well as with incision and drainage, whereas patients with severe disease require hospitalization and intravenous therapy. In addition to community-acquired MRSA, a new strain of Clostridium difficile, BI/NAP1, has led to clinical challenges in infectious diseases medicine. The strain has been associated with recurrent infection; more severe disease that mandates urgent colectomy; and dramatically higher mortality in vulnerable populations, such as older adults. Oral vancomycin, rather than metronidazole, may be slightly more effective in patients with severe disease. Also, new strains of Chlamydia and Treponema are posing potential complications to the treatment of sexually transmitted diseases such that clinicians need to be judicious in selecting antibiotic therapy in accordance with factors related to geography and patient population. [Infect Med. 2008;25:421-424]