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MRSA infections in patients treated with tumour necrosis factor inhibitors
  1. N Akhmed1,
  2. J Lichtenstein2
  1. 1
    Internal Medicine Private Practice, Annapolis, Maryland, USA
  2. 2
    Rheumatology Private Practice and Anne Arundel Medical Center, Annapolis, Maryland, USA
  1. Correspondence to Dr J R Lichtenstein, 205 Ridgely Avenue, Annapolis, MD 21401, USA; jack{at}

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Clinical experience with the three available tumour necrosis factor (TNF) inhibitors (etanercept, infliximab and adalimumab) shows improvement in inflammatory arthritis. Clinical studies have reported serious infections such as reactivation tuberculosis following treatment with TNF inhibitors. Bacterial infections with organisms such as Staphylococcus aureus (both methicillin-sensitive (MSSA) and methicillin-resistant (MRSA)), Streptococcus and Gram-negative organisms have not been reported to be more frequent or severe. We noticed several severe MRSA infections in patients treated with TNF inhibitors and wondered whether these agents might alter the outcome of these infections. We therefore performed a retrospective analysis of patients treated in our practice.

Between August 2003 and July 2006, 430 patients with inflammatory arthritis (rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis) …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.