RESUMEN
Methicillin-resistant Staphylococcus aureus [MRSA] infections in hospital have obviously imposed a significant burden of morbidity and mortality, and strain on healthcare resources. Here, we review the genotype distribution of these pathogens in the Kingdom of Saudi Arabia [KSA]. A PubMed literature search [until May 2014] specified 12 articles that characterized MRSA clones in KSA. Only two regions [Riyadh and Damamm] were represented in ten articles. Data from these articles showed that the pandemic Vienna/Hungarian/Brazilian clone [CC8/ ST239-III] is the most frequent in Saudi regions [Riyadh and Damamm]. Several other clones such as Barnim/ UK-EMRSA-15 [CC22-IV], Southwest Pacific clone [ST30-IV] and European community-associated-MRSA clone [CC80-IV] have been detected in the Riyadh region. A variety of MRSA clones is beginning to circulate in Saudi hospitals. Continued collection and molecular characterization of MRSA is crucial for the effective prevention and treatment
RESUMEN
The purpose of this review is to discuss current international guidelines on the prevention of infective endocarditis [IE]. It has long been considered that all patients with heart conditions predisposing to IE should receive antibiotic prophylaxis when undergoing procedures leading to bacteremia with organisms known to cause endocarditis. However, evidence for this is poor and based on isolated case reports, and on theoretical considerations, rather than on randomized controlled trials. Recently, thinking has changed for 3 main reasons. Firstly, there is now strong evidence that bacteremia with endocarditis-causing organisms frequently occurs following everyday activities, such as tooth-brushing. Secondly, few cases of endocarditis are directly attributable to a preceding procedure. Thirdly, adverse effects of antibiotic use should be given due consideration. Recent international guidelines have radically changed recommendations on this issue, advocating limited, or non-use of antibiotics in a very small group of high-risk individuals for a limited number of invasive procedures