Impact of Methicillin Resistance on the Outcome of Patients With Bacteremia Caused by Staphylococcus aureus

Abstract

Methicillin resistance in patients with S aureus bacteremia had no significant impact on patient outcome as measured by in-hospital mortality after adjustment was made for major confounders.

Length of exposure to the hospital environment is more important than antibiotic exposure in healthcare associated infections by methicillin-resistant Staphylococcus aureus: a comparative study

“…25,28,44 In our study, even though quantitative use of several antibiotic classes and antibiotics as a whole was much heavier in the MRSA group, no quantitative index emerged as independent predictor of HCA-MRSA infections. Graffunder et al showed that quantitative use of levofloxacin was independently associated with MRSA infection.…”

“…These two factors, especially the former, are, without any doubt, among the strongest predictors of MRSA infections in older and newer studies. 4,[9][10][11][12][13][14][15][16][17][18][20][21][22][23][25][26][27][28]33,34 Obviously, differences in our results compared to the above-described studies may be partly due to different study design and differences in populations studied, as noted in a recent meta-analysis. 38 Additionally, from a subanalysis of the blood isolates of our study groups, the mean number of antibiotic-days did emerge as independent predictor of a subsequent HCA-MRSA bacteremia.…”

“…4,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Both total antimicrobial use as well as specific antimicrobial classes have been implicated. [11][12][13][14][15][16][17][18]24,25 Included in these classes are β-lactamic antibiotics, 14,26-33 cephalosporins, 11,12,16,22,29 aminoglycosides, 22,33,34 macrolides, 27 glycopeptides 15,[27][28][29]34 and fluoroquinolones (FQs). 6,11,12,14,[26][27][28][29][35][36][37] A relatively recently published meta-analysis detected a clear association between exposure to antibiotics and MRSA isolation.…”

Real-time evaluation of an optimized real-time PCR assay versus Brilliance chromogenic MRSA agar for the detection of meticillin-resistant Staphylococcus aureus from clinical specimens

“…Meticillin-resistant Staphylococcus aureus (MRSA) remains a leading cause of healthcare-acquired infection and affects the most vulnerable patients with significant morbidity and mortality (Harbarth et al, 1998;Cosgrove et al, 2003;Salgado et al, 2003;Cooper et al, 2004; Francois et al, 2007). Despite the lack of convincing evidence (Coia et al, 2006), it is now accepted that a major aspect of controlling the spread of MRSA is the prompt identification of patients at risk of MRSA carriage (Chaix et al, 1999;Cepeda et al, 2005;Malde et al, 2006;Cunningham et al, 2007).…”

“…However, the reality is that various external factors such as sample collection, transport, reception, documentation and reporting significantly increase the real reporting time, making the target of same-day reporting difficult to achieve (Harbarth et al, 1998; Jeyaratnam et al, 2008;Aldeyab et al, 2009 Only patients who were routinely screened for MRSA were included. The study was carried out in full accordance with clinical governance as stated by NHS Lothian.…”