Risk factors and mortality in patients with nosocomial Staphylococcus aureus bacteremia

Melo

Rev. Latino-Am. Enfermagem

2009

Fortaleza CR, Melo EC, Fortaleza CMCB. Nasopharyngeal colonization with methicillin-resistant staphylococcus aureus and mortality among patients in an intensive care unit. Rev Latino-am Enfermagem 2009 setembrooutubro; 17(5):677-82. (OR=1.02; p=0.97) o por causas infecciosas (OR=0.96; p=0.96 (OR=1,02; IC95%=0, p=0,97) ou por infecção (OR=0,96; IC95%=0,89; p=0,96 Nasopharyngeal colonization with Methicillin-resistant Staphylococcus aureus (MRSA) is common in critically ill

Section: Discussionmentioning

confidence: 75%

Nasopharyngeal colonization with methicillin-resistant staphylococcus aureus and mortality among patients in an intensive care unit

Melo

Rev. Latino-Am. Enfermagem

2009

“…25,26 However, the risk of HAIs in cancer patients is widespread, and the challenges surrounding the detection and prevention of HAIs are equally (if not more) important in these patients given their increased susceptibility to acquiring HAIs. 7,8 In that context, the treatment of cancer patients with surgical intervention is associated with a particularly high incidence of HAI. 27,28 In addition, our analyses demonstrated that black patients consistently had greater odds of HAIs despite simultaneous adjustment for other confounding patient characteristics.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 In response to increased public awareness, many state legislatures have made HAI reporting mandatory; as of 2010, at least 27 states have enacted laws requiring health systems to report HAI rates, 5,6 In the setting of oncologic patients, susceptibility to HAIs may even be greater. 7,8 For most types of cancer, surgery remains a likely intervention when there is curative intent. Ironically, surgical intervention represents a risk factor for developing HAIs, 9 with variations according to age, baseline conditions, case complexity, and subsequent care.…”

Section: Introductionmentioning

confidence: 99%

Health care‐associated infections after major cancer surgery

Sammon

Trinh

Ravi

et al. 2013

Cancer

BACKGROUND: Approximately 1.7 million individuals per year are affected with health care-associated infections (HAIs) in the United States. The authors examined trends in the incidence of HAI after major cancer surgery (MCS) and risk factors for HAI to describe the effects of HAI on mortality after MCS. METHODS: Patients undergoing 1 of 8 MCS procedures within the Nationwide Inpatient Sample between 1999 and 2009 were identified (n ¼ 2,502,686). Generalized linear regression models were used to estimate the impact of the primary predictors (procedure type, age, sex, race, insurance status, Charlson comorbidity index, hospital volume, and hospital bed size) on the odds of HAI and in-hospital mortality. Trends in incidence were evaluated with linear regression. RESULTS: Overall, MCS-associated HAI incidence increased 2.7% per year (P < .001), whereas mortality decreased 1.3% per year (P < .001). (OR, 8.66; 95% CI,. CONCLUSIONS: Between 1999 and 2009, the incidence of MCS-associated HAI events increased; however, HAI-associated mortality decreased. That said, significant disparities exist in the hospital and demographic attributes associated with MCS-associated HAI, with attendant health policy implications. Moreover, HAI remains detrimentally linked to mortality during hospitalization.

“…12 Further research has implicated neoplasia as an independent risk factor for mortality from nosocomial S. aureus bacteraemia. 13 Health economy issues are also relevant given the high costs associated with hospital stay for oncology patients.…”

Section: Discussionmentioning

confidence: 99%

Methicillin-resistant Staphylococcus aureus in surgical patients: identification of high-risk populations for the development of targeted screening programmes

Fraser

Brady

Graham³

et al. 2010

annals

Ann R Coll Surg Engl 2010; 92: 311-315 311The UK has one of the highest methicillin-resistant Staphylococcus aureus (MRSA) to methicillin-sensitive S. aureus (MSSA) blood infection rates in Europe. 1 Recent data indicate that MRSA infection is associated with higher mortality rates and is implicated as the causative organism in 28% cases of S. aureus bacteraemia. 2,3Addressing the level of MRSA hospital-acquired infection (HAI) rates is a major world-wide problem; whilst recent data have demonstrated a trend towards decreasing numbers of MRSA infections, 4 screening for MRSA could potentially allow earlier detection of those with MRSA. This may allow healthcare workers to target resources efficiently in an attempt to decrease rates of MRSA transmission using isolation or decolonisation strategies. 5In order to inform these strategies, further research is urgently required to identify high-risk patient populations in order to direct efficient screening programmes. Screening has now been recommended routinely for all hospital in-patients in some regions; 6 however, whilst these pilot studies will identify the effectiveness of such pro- (7145 surgical in-patients) was performed, for all patients admitted to general surgery at the Royal Infirmary of Edinburgh. Analysis specifically focused on MRSA laboratory data and coding data for patient demographics, medical co-morbidities, and progress of in-patient stay. RESULTS A total of 134 (1.88%) individual patients with colonisation or infection by MRSA were identified from indicated laboratory testing. Univariate analysis identified a significant association of concurrent MRSA-positive status with patients aged over 60 years (P < 0.01), a duration of inpatient stay > 7 days (P < 0.01), presence of a malignant neoplasm (P < 0.01), circulatory disease (P < 0.01), respiratory disease (P < 0.01), central nervous system disease (P < 0.01), renal failure (P < 0.01), and concurrent admission to ITU/HDU (P < 0.01). Multivariate analysis suggested MRSA colonisation or infection was strongest in those with co-morbid malignancy (P < 0.0001) or admission to ITU/HDU (P < 0.0001). CONCLUSIONS This large observational study has identified cancer patients as a UK surgical patient subpopulation which is at significantly higher risk of colonisation by MRSA. These data could inform the development of focused hospital in-patient screening protocols and provide a means to stratify patient risk. GENERAL SURGERY