Risk factors for anti-MRSA drug resistance

Abe, Yasuhisa; Shigemura, Katsumi; Yoshida, Hiroyuki; Fujisawa, Masato; Arakawa, Soichi

doi:10.1016/j.ijantimicag.2012.07.005

Cited by 7 publications

(7 citation statements)

References 25 publications

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“…This was not surprising, given that previous reports have obtained similar results regarding the role of invasive procedures in the drug resistance of S . aureus [ 23 , 24 ]. In addition, we found that a history of multiple hospitalizations was statistically associated with MRSA infections, which is similar to the findings of another recent report [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Healthcare Associated Infections of Methicillin-Resistant Staphylococcus aureus: A Case-Control-Control Study

et al. 2015

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BackgroundMethicillin-resistant Staphylococcus aureus (MRSA) is one of the most widespread and dangerous pathogens in healthcare settings. We carried out this case-control-control study at a tertiary care hospital in Guangzhou, China, to examine the antimicrobial susceptibility patterns, risk factors and clinical outcomes of MRSA infections.MethodsA total of 57 MRSA patients, 116 methicillin-susceptible Staphylococcus aureus (MSSA) patients and 102 S. aureus negative patients were included in this study. We applied the disk diffusion method to compare the antimicrobial susceptibilities of 18 antibiotics between MRSA and MSSA isolates. Risk factors of MRSA infections were evaluated using univariate and multivariate logistic regression models. We used Cox proportional hazards models and logistic regression analysis to assess the hospital stay duration and fatality for patients with MRSA infections.ResultsThe MRSA group had significantly higher resistance rates for most drugs tested compared with the MSSA group. Using MSSA patients as controls, the following independent risk factors of MRSA infections were identified: 3 or more prior hospitalizations (OR 2.8, 95% CI 1.3–5.8, P = 0.007), chronic obstructive pulmonary disease (OR 5.9, 95% CI 1.7–20.7, P = 0.006), and use of a respirator (OR 3.6, 95% CI 1.0–12.9, P = 0.046). With the S. aureus negative patients as controls, use of a respirator (OR 3.8, 95% CI 1.0–13.9, P = 0.047) and tracheal intubation (OR 8.2, 95% CI 1.5–45.1, P = 0.016) were significant risk factors for MRSA infections. MRSA patients had a longer hospital stay duration and higher fatality in comparison with those in the two control groups.ConclusionsMRSA infections substantially increase hospital stay duration and fatality. Thus, MRSA infections are serious issues in this healthcare setting and should receive more attention from clinicians.

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Section: Discussionmentioning

confidence: 99%

Healthcare Associated Infections of Methicillin-Resistant Staphylococcus aureus: A Case-Control-Control Study

et al. 2015

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“…Predictors of a positive urine culture for MRSA include indwelling catheters, urinary tract obstruction, and surgery [3,10]. …”

Section: Discussionmentioning

confidence: 99%

Unexpected Multidrug Resistance of Methicillin-ResistantStaphylococcus aureusin Urine Samples: A Single-Center Study

et al. 2014

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PurposeInfections of methicillin-resistant Staphylococcus aureus (MRSA) are becoming an increasingly concerning clinical problem. The aim of this study was to assess the development of MRSA in urine cultures in a major public university-affiliated hospital and the therapeutical and hygiene-related possibilities for reducing resistance.Materials and MethodsThis study included 243 samples from patients diagnosed with MRSA infection over a period of 6 years. An agar diffusion test measured the effects of antimicrobial agents against bacteria grown in culture. The analyses were based on the guidelines of the Clinical and Laboratory Standards Institute.ResultsA regression analysis was performed, which showed 100% resistance to the following antibiotics throughout the entire testing period: carbapenem, cephalosporin (1st-4th generation), penicillin G, aminopenicillin, β-lactamase, and isoxazolyl penicillin. However, a significant decrease in resistance was found for amikacin, gentamicin, clindamycin, levofloxacin, erythromycin, and mupirocin.ConclusionsMRSA showed a decreasing trend of antimicrobial resistance, except against carbapenem, cephalosporin (1st-4th generation), penicillin G, aminopenicillin, β-lactamase, and isoxazolyl penicillin, for which complete resistance was observed.

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“…9,23 Moreover, we have reported that the MRSA strains with higher MICs to Linezolid showed that this strain was classified as SCCmec type IIa by POT analysis from its band pattern. 11 Maeda et al 6 showed the effectiveness of the POT method for SCCmec typing in skin and soft tissue infection (SSTI)-MRSA in comparison with PFGE, spa typing and multilocus sequence typing, with a simple and rapid platform producing results in as little as 6 h without nucleotide sequencing. They also showed that combined diagnoses by POT scores (POT1-2-3 and POT2-3) had higher discriminatory power but the concordance between POT1-POT2-POT3 and other genotyping methods was not excellent and our results were supported by their findings.…”

Section: Discussionmentioning

confidence: 99%

“…Forty-seven isolates collected from several kinds of materials including urine or blood from patients with infection by MRSA were obtained in Kobe University Hospital between January and December 2009 as described previous study. 11 MRSAs were diagnosed by MRSA selective agar (Becton, Dickinson and Company, Franklin Lakes, NJ, USA).…”

Section: Mrsa Strainsmentioning

confidence: 99%

“…We performed the POT method using the Cica Geneus Staph POT Kit (Kanto Chemical, Tokyo, Japan) according to the manufacturer's protocol as described previous study. 11 The POT method was presented by being categorized as three POT scores (POT 1, POT 2 and POT 3) by a combination of the presence or absence of 22 genetic elements 6,9 using the aforementioned POT kit according to the manufacture's protocol. In brief, (1) overnight culture at 37 1C of MRSA strain, (2) DNA extraction, (3) 4% agarose electrophoresis, (4) Exchange to final POT typing (POT 1, POT 2 and POT 3).…”

Section: Potmentioning

confidence: 99%

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Comparison between phage-open-reading frame typing and automated repetitive-sequence-based PCR for typing MRSA isolates

et al. 2014

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The methods for typing and epidemiological study for especially antibiotic-resistant bacteria has been issued but there are the debates regarding which method is best for this purpose. The purpose of this study is to investigate and apply a comparatively new technology, phage-open-reading frame typing (POT) and repetitive-sequence-based PCR (rep-PCR) using DiversiLab system and compare for the discrimination of major methicillin-resistant Staphylococcus aureus (MRSA) lineages in epidemiological surveillance. We analyzed 47 representative MRSA stains isolated in Kobe University Hospital between January and December 2009. We performed MRSA typing using the POT kit and rep-PCR using the DiversiLab system. POT method classified all the MRSA strains into 35 clusters, whereas rep-PCR method typed all the MRSA strains in 10 kinds of clusters with a definition of 95% similarity. The discriminatory power and congruence between the methods were compared using the Simpson's index of diversity, adjusted Rand's and Wallace's coefficients. Our statistical analyses showed that the POT (POT 1-2-3 and POT 2-3) revealed a higher discriminatory power in the Simpson's index of diversity (SID; 0.969, range 0.939-1.000 and 0.967, range 0.935-0.998, respectively) for MRSA isolates than the rep-PCR (0.821 (0.767-0.876)). The adjusted Rand's and Wallace's coefficients did not show higher concordance among the methods. In conclusion, we demonstrated that the POT can perform accurate and reliable epidemiological surveillance studies for analyzing the genetic relatedness of MRSA strains.

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Risk factors for anti-MRSA drug resistance

Cited by 7 publications

References 25 publications

Healthcare Associated Infections of Methicillin-Resistant Staphylococcus aureus: A Case-Control-Control Study

Healthcare Associated Infections of Methicillin-Resistant Staphylococcus aureus: A Case-Control-Control Study

Unexpected Multidrug Resistance of Methicillin-ResistantStaphylococcus aureusin Urine Samples: A Single-Center Study

Comparison between phage-open-reading frame typing and automated repetitive-sequence-based PCR for typing MRSA isolates

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