Longevity and gender as the risk factors of methicillin-resistant Staphylococcus aureus infections in southern Poland

Abstract

BackgroundThe proportion of older people among the general population has risen. Staphylococcus aureus (SA) constitutes a significant problem. Underlying disease and functional debility, predispose the older adult to staphylococcal carriage and infection, specially bloodstream infection and pneumonia.MethodsThis is a retrospective cohort study of older patients with SA infections. We analyzed a database containing the results of laboratory cultures from patients treated in 2013 for SA infections and selected 613 hospitalized and non-hospitalized people aged ≥60 years.ResultsThe prevalence of Methicillin-resistant SA (MRSA) were significantly different in categories of patients: from 14.1% in young old, 19.5% in old old and 26.7 in longevity. MRSA was significantly more frequently reported in cases of pneumonia, 40.4% of SA strains (p < 0.0001, OR 0.3, 95%CI 0.14–0.49). The nosocomial MRSA infections were more common in ICU departments: prevalence 36.8%, than in non-ICU departments: prevalence 17.3% (OR 2.8, 95%CI 1.06–7.34, p = 0.014). Bloodstream infections, which accounted for 6% of all infections, were more frequent in males (p = 0.0231, OR 2.25, 95%CI 1.098–4.604). The greatest increase in antibiotic resistance was related to trimethoprim/sulfamethoxazole (TMP/SXT), which increased to over 80% in the older study groups. All age groups demonstrated increased MIC90 values for glycopeptide and tigecycline. Although strains isolated from patients in all age groups remained sensitive to vancomycin, strains isolated from patients in the old-old and longevity groups demonstrated resistance to teicoplanin. The MIC90 for tigecycline was the highest in the group aged >90 years.ConclusionsMRSA constitutes a significant epidemiological problem in cases of hospital-treated pneumonia. The findings were similar for long-term-care facilities, where MRSA appears to affect male residents in particular, although there were fewer male residents than female residents. The low sensitivity to TMP/SXT of SA strains isolated from the oldest patients indicates potentially serious challenges pertaining to efficacious treatment of SA infections.

Antibiotic consumption and antimicrobial resistance in Poland; findings and implications

“…Infections in Polish patients illustrate the relationship between high utilisation and high levels of resistance, i.e. the high consumption of trimethoprim and sulfamethoxazole [ 35 ] has been accompanied by high levels of antibiotic resistance [ 5 ]. Having said this, the prevalence of MRSA in Poland in 2013 was 16%, with prevalence rates exceeding 25% in many EU Member States [ 35 ].…”

Aging effects in the expression of macrophages in post‐treatment apical periodontitis lesions

“…Other relevant aspect as a challenge in this study, is related to Brazilian reality, which differs from other countries and the definition of elderly was described in the Statute of the Elderly published by the Ministry of Health in 2013, and considered ≥60 years old. Another study used three categories of older people that were considered ≥60 years old: old age: 60‐74 years; late old age: 75‐85 years; and oldest age (longevity): ≥85 years . Thus, in this study, we considered the term older, including individuals ≥60 years old, once the majority of developed countries worldwide accepted the chronological age up to 65 years as a definition of elderly.…”

Staphylococcus aureus Resistance Patterns in Wisconsin

“…Our findings contrast a European study that reported an increased proportion of MRSA in elderly patients when compared to younger patients. 34 Further investigation may be warranted in subsequent SWOTARE collections to elucidate a role for patient age in terms of risk for MRSA infection in Wisconsin.…”