Risk Factors for Methicillin-Resistance among Patients with Staphylococcus aureus Bacteremia at the Time of Hospital Admission

Rezende, Nilton Alves de; Blumberg, Henry M.; Ray, Susan M.; Metzger, Brian S.; Larsen, Nina; McGowan, John E.

doi:10.1097/00000441-200203000-00001

Cited by 66 publications

(41 citation statements)

References 27 publications

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“…While acknowledging that some MRSA strains may have arisen in the community, the authors concluded that the increase of community-onset MRSA in the community is largely caused by "exporting" of strains as patients are discharged from the hospital. Several other studies published since that meta-analysis similarly have found a high prevalence of nosocomial risk factors in MRSA-colonized community-dwelling patients or their household contacts [20,[37][38][39][40]. Also supportive are the findings of a Swiss national survey of MRSA isolates, which determined that patients colonized with a sporadic strain were more likely than patients with predominant nosocomial strains to have been transferred from a foreign hospital [41].…”

Section: Comparison To Health Care-associated Methicillinresistant Stmentioning

confidence: 68%

Community-acquired methicillin-resistant Staphylococcus aureus: Epidemiology and potential virulence factors

Eguía

Chambers²

2003

Curr Infect Dis Rep

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Methicillin-resistant Staphylococcus aureus (MRSA) has been isolated from patients in the community. Some of these strains may have origins in the hospital, but others appear to be novel and unrelated to known hospital strains. Community MRSA strains have several distinguishing characteristics that may enable them to more readily colonize and infect otherwise healthy individuals. This article reviews recent publications addressing the epidemiology of MRSA in the community, risk factors associated with carriage, potentially associated virulence factors, and concepts of strain fitness as they pertain to MRSA. MRSA likely will be an increasingly important pathogen in the community.

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Section: Comparison To Health Care-associated Methicillinresistant Stmentioning

confidence: 68%

Community-acquired methicillin-resistant Staphylococcus aureus: Epidemiology and potential virulence factors

Eguía

Chambers²

2003

Curr Infect Dis Rep

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“…Characteristics permitting recognition of patients with such strains would aid infection control efforts and choice of empiric therapy pending culture and susceptibility results (Rezende et al, 2002). Therefore, in most instances the physician initiates empiric antibiotics on the basis of epidemiologic data.…”

Section: Resultsmentioning

confidence: 99%

“…or Staphylococcus aureus, which were isolated from the blood cultures of these patients. The median duration from a symptom onset to initiation of effective antibiotics among patients was 4 days.Characteristics permitting recognition of patients with such strains would aid infection control efforts and choice of empiric therapy pending culture and susceptibility results (Rezende et al, 2002). Therefore, in most instances the physician initiates empiric antibiotics on the basis of epidemiologic data.…”

mentioning

confidence: 99%

Community-acquired bacteraemia in a rural area: predominant bacterial species and antibiotic resistance

Nimri

Batchoun

2004

Journal of Medical Microbiology

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The invasion of the bloodstream represents one of the most important sequelae of infection. This study was conducted over an 18-month period to determine the predominant bacterial agents of a community-acquired bacteraemia seen at health centres in a rural area of Jordan, and their antibiotic susceptibilities. Blood samples were collected and cultured from 215 patients who presented with fever and presumed diagnosis of a bacteraemia. Isolates were identified and tested for antibiotic susceptibility. The variables included the age and sex of the patients, aetiology, sources of the bacteraemia, risk factors, treatment and outcome. One hundred and twenty-six (58 . 6 %) blood cultures were positive. Children less than 14 years old accounted for 34 . 9 % of these, and 38 % were from patients that were more than 50 years old. The most frequent aetiologic agents were Staphylococcus aureus, followed by Brucella melitensis and Streptococcus pneumoniae. A wide range of resistance to commonly used antimicrobial agents and multidrug resistance was documented in 44 . 4 % of the isolates. The most frequent sources of the bacteraemia were urinary (15 . 9 %), respiratory (14 . 3 %), no source of the bacteraemia identified (primary bacteraemia) (13 . 5 %), gastrointestinal (12 . 7 %) and soft-tissue infection (7 . 9 %). No identifiable risk factor for infection could be determined in 34 % of the patients. The predominant pathogens identified and the relatively high prevalence of antibiotic resistance of the isolates are most probably due to the nature and lifestyle of this rural population and the use of empiric treatment. Characteristics permitting recognition of patients with such strains would aid infection control efforts in the community. INTRODUCTIONIt has been recognized that the presence of living microorganisms in the blood of a patient carries with it considerable morbidity and mortality . Despite all the advances in medical practices in recent years, bacteraemia continues to be a serious problem that needs immediate attention and treatment. In addition, it is still one of the main causes of mortality despite the existence of numerous antimicrobial agents and an increase in means of support. Patients with community-acquired bacteraemia have diseases with a differing spectrum of pathogens and prognosis. A variety of factors, such as the type of micro-organism, age, the underlying disease and where the bacteraemia was acquired, can change the prognosis of the infection (Cisterna et al., 2001). Bloodstream infections in hospitalized patients are usually attributable to the use of central venous lines. However, in cases of community-acquired bacteraemia, the underlying disease is usually unknown and investigators have attempted to define the factors that influence the outcome of these infections. The bacteraemia in certain infections is considered the best practical way to identify the causative organism because the invasion of the bloodstream represents one of the most important sequelae of infection. The isolation of bac...

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“…7 % in our study is in good agreement with the average level found by Salgado et al The MRSA case from our study had contact with hospitals and nursing homes during the last year. Hospital contact is an important risk factor for the acquisition of MRSA [28][29][30][31]. In addition to the contact to medical institutions, the patient had severe comorbidity like diabetes mellitus and renal failure.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and determinants of nasal colonization with antibiotic-resistant Staphylococcus aureus among unselected patients attending general practitioners in Germany

Lietzau¹,

Stürmer²,

Erb³

et al. 2004

Epidemiol. Infect.

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SUMMARYAlthough the great majority of antibiotics are prescribed outside hospitals, little is known about the prevalence and determinants of antibiotic resistance in the group of outpatients. Nasal swabs were taken from 627 consecutive patients aged 40 years or above attending general practitioners in Southern Germany. Staphylococcus aureus was cultured and minimal inhibitory concentrations to various antibiotics were tested. Nasal swabs of 152 patients were positive for S. aureus. Prevalence of resistance was 68 . 3, 8 . 3 and 0 . 7% for penicillin G, erythromycin, and oxacillin respectively. Antibiotic use within the last month was associated with erythromycin resistance [adjusted odds ratio (OR) 7 . 4 ; 95 % confidence interval (CI) 1 . 0-53]. Besides a high prevalence of resistance to penicillinase-instable antibiotics we found only one (0 . 7 %) methicillin-resistant S. aureus. Recent antibiotic use was associated with increased resistance to erythromycin.

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Risk Factors for Methicillin-Resistance among Patients with Staphylococcus aureus Bacteremia at the Time of Hospital Admission

Cited by 66 publications

References 27 publications

Community-acquired methicillin-resistant Staphylococcus aureus: Epidemiology and potential virulence factors

Community-acquired methicillin-resistant Staphylococcus aureus: Epidemiology and potential virulence factors

Community-acquired bacteraemia in a rural area: predominant bacterial species and antibiotic resistance

Prevalence and determinants of nasal colonization with antibiotic-resistant Staphylococcus aureus among unselected patients attending general practitioners in Germany

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