With the increased use of invasive medical devices comes an increased risk of infection. Dr. Scott Bergman, assistant professor in the SIUE School of Pharmacy Department of Pharmacy Practice, is conducting research focused on the appropriate treatment of multi-drug-resistant organisms that cause healthcare-associated infections. He received a SIUE STEP grant for FY2012 to test combinations of antibiotics against methicillin-resistant Staphylococcus aureus (MRSA), a common pathogen that causes infections in hospitalized patients.
Standard MRSA treatments do not yield ideal cure rates in patients with prosthetic joint infections. Bergman focused on organisms isolated from patients with osteoarticular infections, primarily prosthetic joint infections, to address the need for improved therapy. “When MRSA attaches to smooth surfaces like bone, metal or plastic, it forms a thick coating, called biofilm, which is difficult to remove. It’s similar to tooth plaque that needs to be brushed off,” Bergman explains. Additionally, bacteria within the biofilm often mutate and develop antibiotic resistance. For example, rifampin, an especially potent antibiotic against MRSA biofilms, is rendered ineffective after a single-step mutation.
To improve MRSA treatment, Bergman examined current methods of combination antibiotic therapy. When doctors suspect an infection and do not know the specific causative organism and its susceptibility to antibiotics, vancomycin, the gold standard MRSA treatment, is usually started alone. After doctors identify a multi-drug resistant pathogen, a second Combination therapy has been shown to improve outcomes, but the ideal timing of adding the second antibiotic has yet to be established. Bergman’s study examines how administering the second antibiotic at different times affects outcomes. His results show that whether rifampin was started on day one or two of therapy, the concentrations of antibiotic needed to inhibit bacteria released from simulated biofilm infections in the laboratory did not differ. The results of this research were presented at the Interscience Conference on Antimicrobial Agent Chemotherapy in San Francisco, California last fall.
Bergman is also interested in treatment for serious infections outside of hospitals. Treatment drugs for serious infections may be continued intravenously for six weeks or longer after a patient has left the hospital. Bergman’s current project investigates the monitoring of intravenous therapy patients after being discharged from the hospital. Through laboratory findings and clinical outcomes, Bergman’s initial results indicate that physicians who are not specialists in infectious diseases do not monitor long-term antibiotics as closely as experts recommend. His goal is for hospital pharmacists to recommend monitoring parameters and increase compliance with national guidelines for these drugs. Bergman believes this will improve the safety and success of a cost-effective mode of healthcare delivery. This work was made possible by an Infectious Diseases Pharmacotherapy Residency Grant from the Society of Infectious Diseases Pharmacists.
Another of Bergman’s research projects focusing on the involvement of pharmacists in patient care was recognized by the Illinois Pharmacists Association. Bergman is the 2012 recipient of the Excellence in Innovation Award, sponsored by Upsher-Smith Laboratories. Bergman received the award for his work involving rapid testing for influenza in community pharmacies. The outcome of this study showed that patients with influenza symptoms testing positive in the pharmacy could be treated significantly faster when pharmacists were able to initiate antivirals under standing orders from a physician, rather than referring them to a physician for evaluation. Bergman would like to publish the findings from the study in the near future.