Methicillin-resistant Staphylococcus aureus bacteraemia in Western Australian teaching hospitals, 1997–1999: risk factors, outcomes and implications for management

Cordova, Suzanne; Heath, Christopher H.; McGechie, D.B.; Keil, Anthony D.; Beers, Mary; Riley, Thomas V.

doi:10.1016/j.jhin.2003.10.009

Cited by 24 publications

(16 citation statements)

References 20 publications

(26 reference statements)

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“…A recurrence rate of 9% in another study suggested that it was a way of measuring adequacy of treatment. 7 The mean age of 71.7 years in this study is higher than in other studies. [7][8][9][10][11] The median age in the present study was 76 years, with almost three-quarters of patients over the age of 65 years.…”

Section: Discussioncontrasting

confidence: 68%

Community-onset healthcare-associated MRSA bacteraemia in a district general hospital

Karas

Enoch

Emery

2006

Journal of Hospital Infection

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Section: Discussioncontrasting

confidence: 68%

Community-onset healthcare-associated MRSA bacteraemia in a district general hospital

Karas

Enoch

Emery

2006

Journal of Hospital Infection

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“…Risk factors for methicillin resistance reported in literature also vary among institutions and patients. The major independent risk factors include: advanced age 19,20 , residence in a nursing home 7,21 , long duration of hospitalization 4 , prior antibiotic exposure 6,22 , insulin-requiring diabetes 23 , intravascular devices 3,24 , presence of decubitus ulcers or pneumonia as source of BSI 6,15,24 , inadequacy of antimicrobial therapy, and severity of clinical status 13 . In the present study, based on univariate analysis, age and presence of central venous catheter (CVC) were risk factors for MRSA bacteraemia as also reported previously 10,13 .…”

Section: Ethical Considerationsmentioning

confidence: 99%

Methicillin-resistant Staphylococcus aureus bloodstream infection: risk factors and clinical outcome in non-intensive-care units

Naves

Trindade

Filho

2012

Rev. Soc. Bras. Med. Trop.

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INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) is spread out in hospitals across different regions of the world and is regarded as the major agent of nosocomial infections, causing infections such as skin and soft tissue pneumonia and sepsis. The aim of this study was to identify risk factors for methicillin-resistance in Staphylococcus aureus bloodstream infection (BSI) and the predictive factors for death. METHODS: A retrospective cohort of fifty-one patients presenting bacteraemia due to S. aureus between September 2006 and September 2008 was analysed. Staphylococcu aureus samples were obtained from blood cultures performed by clinical hospital microbiology laboratory from the Uberlândia Federal University. Methicillinresistance was determined by growth on oxacillin screen agar and antimicrobial susceptibility by means of the disk diffusion method. RESULTS: We found similar numbers of MRSA (56.8%) and methicillin-susceptible Staphylococcus aureus (MSSA) (43.2%) infections, and the overall hospital mortality ratio was 47%, predominantly in MRSA group (70.8% vs. 29.2%) (p=0.05). Age (p=0.02) was significantly higher in MRSA patients as also was the use of central venous catheter (p=0.02). The use of two or more antimicrobial agents (p=0.03) and the length of hospital stay prior to bacteraemia superior to seven days (p=0.006) were associated with mortality. High odds ratio value was observed in cardiopathy as comorbidity. CONCLUSIONS: Despite several risk factors associated with MRSA and MSSA infection, the use of two or more antimicrobial agents was the unique independent variable associated with mortality.

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“…Cordova et al described an incidence of 0.25/1000 admissions [13] , Jensen et al [14] , in a study that did not discriminate between MRSA and Methicillin-Sensitive S. Aureus (MSSA), observed an incidence of 0.7/1000 admissions and Tacconelli et al [15] observed 1.3 cases of MRSA/1000 admissions during the first 24 h after hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Bacteremia and Predictors of Mortality of Patients with Bloodstream Infection with Methicillin-Resistant Staphylococcus aureus

Bakowski¹,

Wey²,

Medeiros³

2008

American J. of Infectious Diseases

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Abstract:The objective of this study was to evaluate the incidence of infection and the risk factors associated to bacteraemia and mortality due to Methicillin-Resistant Staphylococcus Aureus (MRSA). This cohort study, conducted from August 2004 through November 2005, involved 60 consecutively identified patients with bloodstream MRSA infection. The control group included 240 non-infected patients, randomly selected and hospitalized on the day, or immediately after, results of blood culture of case patients were available. A case-control (1:4) study was conducted for evaluation of risk factors for bacteraemia and death. The incidence of infection was 1.99/1000 admissions. Mortality rates were 30% among patients and 5.38% among controls, with an attributed death rate of 24.6%. Multivariate analysis indicated the following risk factors for bacteraemia: severity predictors McCabe = 1, ASA>2 or APACHE II>10 (OR: 4.1; 95% CI: 1.8 -9.4) and use of central venous catheter (OR: 7.3; 95% CI: 2.4-22.2). University analysis showed as risk factors for mortality: age (OR: 1.08; 95% CI: 1.03-1.12), severity predictors McCabe = 1, ASA > 2 or APACHE II > 10 (OR: 9.13; 95% CI: 2.57-32.35), use of mechanical ventilation (OR: 10.32; 95% CI: 1.78-59.51) and use of corticoids (OR: 9.96; 95% CI: 2.69-36.78). Our results when investigating risk factors for bacteremia and mortality due to MRSA showed moderate influence of control group selection, in comparison to studies in which methicillinsensitive S. aureus infection is used as control.

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Methicillin-resistant Staphylococcus aureus bacteraemia in Western Australian teaching hospitals, 1997–1999: risk factors, outcomes and implications for management

Cited by 24 publications

References 20 publications

Community-onset healthcare-associated MRSA bacteraemia in a district general hospital

Community-onset healthcare-associated MRSA bacteraemia in a district general hospital

Methicillin-resistant Staphylococcus aureus bloodstream infection: risk factors and clinical outcome in non-intensive-care units

Risk Factors for Bacteremia and Predictors of Mortality of Patients with Bloodstream Infection with Methicillin-Resistant Staphylococcus aureus

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