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

Bakowski, Elcio; Wey, Sergio Barsantini; Medeiros, Eduardo Alexandrino

doi:10.3844/ajidsp.2008.174.178

Cited by 3 publications

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“…Previous studies have shown urinary catheters to be an independent risk factor for HA-MRSA [ 40 – 42 ]. Previously, the association between urinary catheterization and mortality due to MRSA bacteremia has been mostly inconclusive [ 43 , 44 ]. However, our data showed a positive correlation between indwelling urinary catheters and mortality due to MRSA.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Epidemiology, clinical characteristics, and outcomes in the older patients in a tertiary teaching hospital in Malaysia

et al. 2023

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Background Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is a major concern in the global healthcare system. However, data from Asian regions dealing with the singularity of this infection in older persons is lacking. We aimed to identify the differences in the clinical characteristics and outcomes of MRSA bacteremia between adults aged 18–64 and ≥ 65 years. Methods A retrospective study cohort was conducted at the University Malaya Medical Centre (UMMC) on cases of MRSA bacteremia from 2012 to 2016. Patient demographic and clinical data were collected for risk factors analyses. Results New cases of MRSA bacteremia showed a trend of increase from 0.12 to 100 admissions in 2012 to 0.17 per 100 admissions in 2016 but a drop was observed in 2014 (0.07 per 100 admissions). Out of the 275 patients with MRSA bacteremia, 139 (50.5%) patients were aged ≥ 65 years old. Co-morbidities and severity at presentation were significantly higher among older adults, including diabetes mellitus (p = 0.035), hypertension (p = 0.001), and ischemic heart disease (p < 0.001), as well as higher Charlson Comorbidity Index (p < 0.001) and Pitt bacteremia scores (p = 0.016). Central line-associated bloodstream infections were more common among younger patients (37.5% vs. 17.3% in older patients, p < 0.001), while skin and soft tissue infections are more frequent among older adults (20.9% vs. 10.3% in younger patients, p = 0.016). All-cause mortality and in-hospital mortality were significantly higher in older patients (82.7% and 56.1% vs. 63.2% and 28.7% in younger patients, p < 0.001). Multivariate analysis revealed age ≥ 65 years (adjusted odds ratio: 3.36; 95% confidence interval: 1.24–9.13), Pitt score ≥ 3 (2.15; 1.54–3.01), hospital (6.12; 1.81–20.72) and healthcare (3.19; 1.30–7.81) acquisition of MRSA, indwelling urinary catheters (5.43; 1.39–21.23), inappropriate targeted treatment (8.08; 1.15–56.86), lack of infectious disease team consultation (2.90; 1.04–8.11) and hypoalbuminemia (3.31; 1.25–8.79), were significant risk factors for 30-day mortality. Conclusion Older patients’ risk of mortality from MRSA bacteremia was three times higher than younger patients. Our data will contribute to developing and validating a robust scoring system for risk-stratifying patients to achieve better management and improved clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Evaluation of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Epidemiology, clinical characteristics, and outcomes in the older patients in a tertiary teaching hospital in Malaysia

et al. 2023

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“…In a study of 60 MRSA bacteraemia patients and 240 non-infected controls, Bakowski et al . identified severity of illness and use of central venous catheters as independent risk factors for MRSA bacteraemia [20]. In addition, previous surgery was protective against acquiring MRSA bacteraemia.…”

Section: Discussionmentioning

confidence: 99%

“…Several researchers have attempted to identify predictors of MRSA bacteraemia in hospitals [12, 14–20]. However, the majority of studies were limited by small samples, single-site settings and methodological issues such as inadequate control for severity of illness.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for methicillin-resistantStaphylococcus aureusbacteraemia differ depending on the control group chosen

2013

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SUMMARY Methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia cause significant morbidity and mortality in hospitalized patients. Using a nested case-control design, 204 MRSA bacteraemia cases were compared to 301 unmatched methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia controls and were matched 1:2 with non-infected controls. The independent risk factors for MRSA bacteraemia compared to MSSA bacteraemia were older age (P=0·048), major organ transplant during current hospital stay (P=0·016) and quinolone use (P=0·016). Cases were more likely than non-infected controls to have renal failure (P=0·003), cirrhosis (P=0·013), and a central venous catheter (P=0·003) after controlling for other risk factors. This large case-control study made it possible to assess risk factors for MRSA bacteraemia using two sets of controls and showed that risk factors differed greatly depending on the control group chosen. These results confirm the need for careful selection of appropriate control groups and the need to carefully adjust for underlying severity of illness.

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Risk Factors Associated with Methicillin Resistance amongStaphylococcus aureusInfections in Veterans

McCarthy¹,

Sullivan

Gaynes

et al. 2010

Infect. Control Hosp. Epidemiol.

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

Cited by 3 publications

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Evaluation of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Epidemiology, clinical characteristics, and outcomes in the older patients in a tertiary teaching hospital in Malaysia

Evaluation of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Epidemiology, clinical characteristics, and outcomes in the older patients in a tertiary teaching hospital in Malaysia

Risk factors for methicillin-resistantStaphylococcus aureusbacteraemia differ depending on the control group chosen

Risk Factors Associated with Methicillin Resistance amongStaphylococcus aureusInfections in Veterans

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