Methicillin-resistant Staphylococcus aureus: investigation of a hospital outbreak using a case-control study

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

“…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.…”

“…These results are in agreement with prior studies, looking at qualitative use of those antibiotics. 6,11,12,14,22,[26][27][28][29][33][34][35][36][37][38] Additionally, use of at least two different antibiotics during the previous month was at the border of statistical significance. The underlying mechanisms have not been completely clarified but several lines of evidence exist.…”

“…[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. Significant risk ratios were found for FQs, glycopeptides, cephalosporins and other β-lactams.…”

“…[4][5][6][7][8] Risk factors for healthcare-associated MRSA acquisition and infection include age, duration of hospitalization, underlying disease, neonatal or adult ICU or burn unit location, invasive procedures or devices, previous hospitalization, intensity of care, number of inter-ward transfers, coma, low physical function, serum albumin, pressure sores, immunosuppression, proximity to a MRSA-colonized patient, underlying dermatological disease, enteral feedings. 4,[9][10][11][12][13][14][15][16][17][18] The issue of antibiotic use as a risk factor is complex and still not completely clarified in full detail. Administration of multiple antibiotics and multiple courses of antibiotics were a…”

“…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.…”