scholarly journals 1230. Epidemiology and Risk Factors for Recurrent Invasive Methicillin-Resistant Staphylococcus aureus Infection: nine US States, 2006–2013

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S373-S374
Author(s):  
Ian Kracalik ◽  
Kelly Jackson ◽  
Joelle Nadle ◽  
Wendy Bamberg ◽  
Susan Petit ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Infection Type ◽  
The United States ◽  
Emerging Infections ◽  
Methicillin Resistant ◽  
Initial Infection ◽  
Joint Infections ◽  
Mrsa Infection

Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) causes >70,000 invasive infections annually in the United States, and recurrent infections pose a major clinical challenge. We examined risk factors for recurrent MRSA infections. Methods We identified patients with an initial invasive MRSA infection (isolation from a normally sterile body site) from 2006 to 2013, through active, population-based surveillance in selected counties in nine states through the Emerging Infections Program. Recurrence was defined as invasive MRSA isolation >30 days after initial isolation. We used logistic regression with backwards selection to evaluate adjusted odds ratios (aOR) associated with recurrence within 180 days, prior healthcare exposures, and initial infection type, controlling for patient demographics and comorbidities. Results Among 24,478 patients with invasive MRSA, 3,976 (16%) experienced a recurrence, including 61% (2,438) within 180 days. Risk factors for recurrence were: injection drug use (IDU) (aOR; 1.38, 95% confidence interval [CI]: 1.15–1.65), central venous catheters (aOR; 1.35, 95% CI: 1.22–1.51), dialysis (aOR; 2.00, 95% CI: 1.74–2.31), and history of MRSA colonization (aOR; 1.35, 95% CI: 1.22–1.51) (figure). Recurrence was more likely for bloodstream infections (BSI) without another infection (aOR; 2.08, 95% CI: 1.74–2.48), endocarditis (aOR; 1.46, 95% CI: 1.16–1.55), and bone/joint infections (aOR; 1.38, 95% CI: 1.20–1.59), and less likely for pneumonia (aOR: 0.75, 95% CI: 0.64–0.89), compared with other initial infection types. When assessed separately, the presence of a secondary BSI with another infection increased the odds of recurrence over that infection without a BSI (aOR: 1.96, 95% CI: 1.68–2.30). Conclusion Approximately one in six persons with invasive MRSA infection had recurrence. We identified potential opportunities to prevent recurrence through infection control (e.g., management and early removal of central catheters). Other possible areas for preventing recurrence include improving the management of patients with BSI and bone/joint infections (including both during and after antibiotic treatment) and mitigating risk of infection from IDU. Disclosures All authors: No reported disclosures.

scholarly journals Identifying patient-level risk factors associated with non-β-lactam resistance outcomes in invasive methicillin-resistant Staphylococcus aureus infections in the United States using chain graphs

2021 ◽  
Author(s):  
William Love ◽  
Christine A. Wang ◽  
Cristina Lanzas
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Blood Culture ◽  
Graphical Models ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
The United States ◽  
Emerging Infections ◽  
Methicillin Resistant ◽  
Factors Associated ◽  
Chain Graphs

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common causes of hospital- and community-acquired infections. MRSA is resistant to many antibiotics, including β-lactam antibiotics, fluoroquinolones, lincosamides, macrolides, aminoglycosides, tetracyclines, and chloramphenicol. Graphical models such as chain graphs can be used to quantify and visualize the interactions among multiple resistant outcomes and their explanatory variables. In this study, we analyzed MRSA surveillance data collected by the Centers for Disease Control and Prevention (CDC) as part of the Emerging Infections Program (EIP) using chain graphs with the objective of identifying risk factors for individual phenotypic resistance outcomes (reported as minimum inhibitory concentration, MIC) while considering the correlations among themselves. Some phenotypic resistances have low connectivity to other outcomes or predictors (e.g. tetracycline, vancomycin, doxycycline, and rifampin). Levofloxacin was the only resistant associated with healthcare use. Blood culture was the most common predictor of MIC. Patients with positive blood culture had significantly increased MIC to chloramphenicol, erythromycin, gentamicin, lincomycin, and mupirocin, and decreased daptomycin and rifampin MICs. Chain graphs show the unique and common risk factors associated with resistance outcomes.

Increasing rates of community-acquired methicillin-resistant Staphylococcus aureus infections among HIV-infected persons

2007 ◽  
Vol 18 (8) ◽  
pp. 521-526 ◽  
Author(s):  
Nancy F Crum-Cianflone ◽  
Alina A Burgi ◽  
Braden R Hale
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
General Population ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Incidence Rates ◽  
Hiv Viral Load ◽  
Syphilis Infection ◽  
Methicillin Resistant ◽  
History Of ◽  
Mrsa Infection

Community-acquired (CA) methicillin-resistant Staphylococcus aureus (MRSA) rates have rapidly increased in the general population; however, little data on recent incidence rates and risk factors of CA-MRSA infections among HIV patients appear in the literature. A retrospective study was conducted from 1993 through 2005 among patients at a large HIV clinic. Trends in CA-MRSA infection incidence rates, clinical characteristics and risk factors for CA-MRSA were evaluated. Seven percent of our cohort developed a CA-MRSA infection during the study period. The rate of CA-MRSA infections among HIV-infected population significantly increased since 2003, with an incidence of 40.3 cases/1000 person-years in 2005, which was 18-fold higher than the general population served at our facility. In all, 90% of infections were skin/soft tissue infections with a predilection for buttock or scrotal abscess formation; 21% of patients experienced a recurrent infection. Risk factors included a low CD4 count at the time of infection (odds ratio [OR] per 100 CD4 cells 0.84, P = 0.03), high maximum log10 HIV viral load (OR 4.54, P<0.001), recent use of β-lactam antibiotics (OR 6.0 for receipt of two prescriptions, P<0.001) and a history of syphilis (OR 4.55, P = 0.01). No patient receiving trimethoprim-sulfamethoxazole prophylaxis developed a CA-MRSA infection. Over the study period, CA-MRSA accounted for an increasing percentage of positive wound cultures and Staphylococcus aureus isolates, 37% and 65%, respectively, during 2005. In conclusion, CA-MRSA infections have rapidly increased among HIV-infected patients, a group which has a higher rate of these infections than the general population. Risk factors for CA-MRSA among HIV-infected patients include low current CD4 cell count, recent β-lactam antibiotic use and potentially high-risk sexual activity as demonstrated by a history of syphilis infection.

Risk factors for methicillin-resistant staphylococcus aureus (MRSA) infection in a Japanese geriatric hospital

Public Health ◽  
1997 ◽  
Vol 111 (3) ◽  
pp. 187-190 ◽  
Author(s):  
M Washio ◽  
T Mizoue ◽  
T Kajioka ◽  
T Yoshimitsu ◽  
M Okayama ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistant ◽  
Geriatric Hospital ◽  
Mrsa Infection

scholarly journals The Prevalence, Risk, and Management of Methicillin-Resistant Staphylococcus aureus Infection in Diverse Populations across Canada: A Systematic Review

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 393 ◽  
Author(s):  
Elena Mitevska ◽  
Britney Wong ◽  
Bas G. J. Surewaard ◽  
Craig N. Jenne
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Infection Control ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Control Measures ◽  
Diverse Populations ◽  
Methicillin Resistant ◽  
Infection Control Measures ◽  
Mrsa Infection

Methicillin-resistant Staphylococcus aureus (MRSA) first emerged after methicillin was introduced to combat penicillin resistance, and its prevalence in Canada has increased since the first MRSA outbreak in the early 1980s. We reviewed the existing literature on MRSA prevalence in Canada over time and in diverse populations across the country. MRSA prevalence increased steadily in the 1990s and 2000s and remains a public health concern in Canada, especially among vulnerable populations, such as rural, remote, and Indigenous communities. Antibiotic resistance patterns and risk factors for MRSA infection were also reported. All studies reported high susceptibility (>85%) to trimethoprim-sulfamethoxazole, with no significant resistance reported for vancomycin, linezolid, or rifampin. While MRSA continues to have susceptibility to several antibiotics, the high and sometimes variable resistance rates to other drugs underscores the importance of antimicrobial stewardship. Risk factors for high MRSA infection rates related to infection control measures, low socioeconomic status, and personal demographic characteristics were also reported. Additional surveillance, infection control measures, enhanced anti-microbial stewardship, and community education programs are necessary to decrease MRSA prevalence and minimize the public health risk posed by this pathogen.

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