Determinants of Outcome in Hospitalized Patients With Methicillin-Resistant Staphylococcus aureus Bloodstream Infection: Results From National Surveillance in Canada, 2008-2012

2016 ◽  
Vol 37 (4) ◽  
pp. 390-397 ◽  
Author(s):  
Andrew E. Simor ◽  
Linda Pelude ◽  
George Golding ◽  
Rachel Fernandes ◽  
Elizabeth Bryce ◽  
...  

BACKGROUNDBloodstream infection (BSI) due to methicillin-resistant Staphylococcus aureus (MRSA) is associated with considerable morbidity and mortality.OBJECTIVETo determine the incidence of MRSA BSI in Canadian hospitals and to identify variables associated with increased mortality.METHODSProspective surveillance for MRSA BSI conducted in 53 Canadian hospitals from January 1, 2008, through December 31, 2012. Thirty-day all-cause mortality was determined, and logistic regression analysis was used to identify variables associated with mortality.RESULTSA total of 1,753 patients with MRSA BSI were identified (incidence, 0.45 per 1,000 admissions). The most common sites presumed to be the source of infection were skin/soft tissue (26.6%) and an intravascular catheter (22.0%). The most common spa types causing MRSA BSI were t002 (USA100/800; 55%) and t008 (USA300; 29%). Thirty-day all-cause mortality was 23.8%. Mortality was associated with increasing age (odds ratio, 1.03 per year [95% CI, 1.02–1.04]), the presence of pleuropulmonary infection (2.3 [1.4–3.7]), transfer to an intensive care unit (3.2 [2.1–5.0]), and failure to receive appropriate antimicrobial therapy within 24 hours of MRSA identification (3.2 [2.1–5.0]); a skin/soft-tissue source of BSI was associated with decreased mortality (0.5 [0.3–0.9]). MRSA genotype and reduced susceptibility to vancomycin were not associated with risk of death.CONCLUSIONSThis study provides additional insight into the relative impact of various host and microbial factors associated with mortality in patients with MRSA BSI. The results emphasize the importance of ensuring timely receipt of appropriate antimicrobial agents to reduce the risk of an adverse outcome.Infect. Control Hosp. Epidemiol. 2016;37(4):390–397

2012 ◽  
Vol 45 (2) ◽  
pp. 189-193 ◽  
Author(s):  
Karinne Spirandelli Carvalho Naves ◽  
Natália Vaz da Trindade ◽  
Paulo Pinto Gontijo Filho

INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) is spread out in hospitals across different regions of the world and is regarded as the major agent of nosocomial infections, causing infections such as skin and soft tissue pneumonia and sepsis. The aim of this study was to identify risk factors for methicillin-resistance in Staphylococcus aureus bloodstream infection (BSI) and the predictive factors for death. METHODS: A retrospective cohort of fifty-one patients presenting bacteraemia due to S. aureus between September 2006 and September 2008 was analysed. Staphylococcu aureus samples were obtained from blood cultures performed by clinical hospital microbiology laboratory from the Uberlândia Federal University. Methicillinresistance was determined by growth on oxacillin screen agar and antimicrobial susceptibility by means of the disk diffusion method. RESULTS: We found similar numbers of MRSA (56.8%) and methicillin-susceptible Staphylococcus aureus (MSSA) (43.2%) infections, and the overall hospital mortality ratio was 47%, predominantly in MRSA group (70.8% vs. 29.2%) (p=0.05). Age (p=0.02) was significantly higher in MRSA patients as also was the use of central venous catheter (p=0.02). The use of two or more antimicrobial agents (p=0.03) and the length of hospital stay prior to bacteraemia superior to seven days (p=0.006) were associated with mortality. High odds ratio value was observed in cardiopathy as comorbidity. CONCLUSIONS: Despite several risk factors associated with MRSA and MSSA infection, the use of two or more antimicrobial agents was the unique independent variable associated with mortality.


2014 ◽  
Vol 35 (10) ◽  
pp. 1286-1289 ◽  
Author(s):  
Arthur W. Baker ◽  
Michael J. Durkin ◽  
Kristen V. Dicks ◽  
Sarah S. Lewis ◽  
Rebekah W. Moehring ◽  
...  

Hospitals must report cases of methicillin-resistant Staphylococcus aureus bloodstream infection (BSI) using a new laboratory-identified (LabID) event reporting module. BSI rates obtained using LabID differ from rates of BSI obtained from traditional surveillance (concordance of healthcare facility–onset cases, 61%–76%) because definitions used to report LabID events are inconsistent with traditional BSI definitionsInfect Control Hosp Epidemiol 2014;35(10):1286–1289


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