A diabetic patient developed cellulitis due to S. aureus, which was found to be methicillin resistant after antibiotic sensitivity testing. All of the following antibiotics will be appropriate except
1. "The carbapenem lmipenem has excellent activity against methicillin - sensitive S. aureus but not M.R.S.A." Because MRSA is resistant to all Beta-lactam antibiotics including cephalosporins and carbapenems. 2. Treatment of MRSA: DOC- Vancomycin Alternative drugs- Teicoplanin, Linezolid, Daptomycin (for endocarditis and complicated skin infections), Quinupristin/Dalfopristin, tigecycline and oritavancin. Mupirocin 2% ointment (for nasal carriers of MRSA). 3. Detection of MRSA Antimicrobial susceptibility test: Disk diffusion test can be done by using cefoxitin or oxacillin disks. Cefoxitin is the recommended disk to be used. If oxacillin disk is used, then ceain conditions are to be maintained such as--using media containing 2-4% NaCl, incubation at 30 degC for 24 hours. Oxacillin screen agar: Adding oxacillin 6 mg/ml and NaCl (2-4%) to the medium. PCR detecting mecA gene. Latex agglutination test detecting PBP-2a.
Vancomycin
lmipenem
Teicoplanin
Linezolid
Systemic Bacteriology (Gram Positive Cocci, Gram Negative Cocci)