Clinical and economic impact of methicillin resistance in patients with Staphylococcus aureus bacteremia

Lodise, Thomas P.; McKinnon, Peggy S.

doi:10.1016/j.diagmicrobio.2005.02.007

Cited by 175 publications

(99 citation statements)

References 52 publications

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“…15,16 These patients require barrier care in side rooms (according to current guidelines), a situation which is not always easy to manage, especially in an emergency setting. However, adherence to current guidelines, with isolation measures to reduce MRSA transmission, is supported by a recent systematic review.…”

Section: Discussionmentioning

confidence: 99%

Clinical impact of MRSA in a stem cell transplant unit: analysis before, during and after an MRSA outbreak

Shaw

Boswell

Byrne

et al. 2007

Bone Marrow Transplant

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Section: Discussionmentioning

confidence: 99%

Clinical impact of MRSA in a stem cell transplant unit: analysis before, during and after an MRSA outbreak

Shaw

Boswell

Byrne

et al. 2007

Bone Marrow Transplant

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“…Patients with MRSA bacteremia have been shown to have a higher mortality risk and higher healthcare costs than those with MSSA infections, and a meta-analysis of 31 studies of patients with S. aureus bloodstream infections demonstrated a significant increase in mortality among patients with MRSA vs. MSSA bacteremia. [18][19][20] Outcomes when comparing MRSA and MSSA in VAP are slightly more variable. A higher rate of mortality has been reported in patients with pneumonia caused by MRSA vs. MSSA, but others found no difference after controlling for potential confounders.…”

Section: Discussionmentioning

confidence: 99%

Clinical and economic outcomes in patients with community‐acquired Staphylococcus aureus pneumonia

Taneja

Haque

Oster

et al. 2010

Journal of Hospital Medicine

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BACKGROUND:While the clinical and economic consequences of S. aureus pneumonia in healthcare settings have been well documented, much less is known about community‐acquired S. aureus pneumonia (CAP).METHODS:We retrospectively identified all patients admitted to a large US urban teaching hospital between January 2005 and May 2008 with pneumonia and positive blood or respiratory cultures for S. aureus within 48 hours of admission. Patients with suspected healthcare‐associated pneumonia (HCAP) were excluded from the study sample, using established criteria (eg, recent hospitalization, admission from nursing home, hemodialysis). Patients were designated as having methicillin‐resistant (MRSA) or methicillin‐susceptible (MSSA) CAP based on initial S. aureus isolates. Initial therapy was designated “appropriate” vs. “inappropriate” based on expected susceptibility of the organism to the regimen received.RESULTS:We identified a total of 128 CAP patients with S. aureus isolates; mean (standard deviation [SD]) age was 60 (17) years. A total of 55 patients (43%) had initial cultures positive for MRSA. Patients with MRSA CAP were more likely to receive inappropriate initial therapy (24 [44%] vs. 13 [18%] for MSSA; P = 0.002). Approximately 25% of all patients underwent surgery for pneumonia, 69% received mechanical ventilation, 79% were admitted to intensive care unit (ICU), and 24% died in hospital. Mean (SD) length of stay was 17.0 (15.7) days, and total hospital charges averaged $127,922 ($154,605) per patient; there were no significant differences between patients with MRSA vs. MSSA CAP.CONCLUSION:Outcomes are poor, hospital stays are long, and costs of care are high in patients with S. aureus CAP, and do not differ between those with MRSA vs. MSSA. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine.

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“…Most of authors agree that vancomycin should be added to the empirical therapy but they also agree that vancomycin is not optimal therapy for S. aureus infections. Based on the available data that vancomycin is inferior to beta-lactam therapy for MSSA, Lodise Jr. et al [8] have suggested that the empirical therapy with both a beta-lactam and an anti-MRSA agent should be considered for serious S. aureus infections. Conversely, Wenzel et al [9] suggested that beta lactam antibiotic should not be used when in suspected CA-MRSA infection due to the potential risk of aggravated the infection as beta-lactam antibiotics upregulated PVL messenger RNA in several in vitro studies.…”

Section: Discussionmentioning

confidence: 99%

First reported case of infective endocarditis caused by community-acquired methicillin-resistant Staphylococcus aureus not associated with healthcare contact in Brazil

et al. 2008

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Clinical and economic impact of methicillin resistance in patients with Staphylococcus aureus bacteremia

Cited by 175 publications

References 52 publications

Clinical impact of MRSA in a stem cell transplant unit: analysis before, during and after an MRSA outbreak

Clinical impact of MRSA in a stem cell transplant unit: analysis before, during and after an MRSA outbreak

Clinical and economic outcomes in patients with community‐acquired Staphylococcus aureus pneumonia

First reported case of infective endocarditis caused by community-acquired methicillin-resistant Staphylococcus aureus not associated with healthcare contact in Brazil

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