scholarly journals Incidence and Risk Factors of Ocular Infection Caused by Staphylococcus aureus Bacteremia

2016 ◽  
Vol 60 (4) ◽  
pp. 2012-2017 ◽  
Author(s):  
Jiwon Jung ◽  
Junyeop Lee ◽  
Shi Nae Yu ◽  
Yong Kyun Kim ◽  
Ju Young Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Tertiary Care ◽  
Ocular Infection ◽  
Ocular Involvement ◽  
Care Hospital ◽  
Content Type ◽  
Ocular Infections ◽  
Metastatic Infection

ABSTRACTStaphylococcus aureusbacteremia (SAB) often leads to ocular infections, including endophthalmitis and chorioretinitis. However, the incidence, risk factors, and outcomes of ocular infections complicated by SAB are largely unknown. We retrospectively analyzed the incidence and risk factors of ocular involvement in a prospective cohort of patients with SAB at a tertiary-care hospital. Ophthalmologists reviewed the fundoscopic findings and classified the ocular infections as endophthalmitis or chorioretinitis. During the 5-year study period, 1,109 patients had SAB, and data for 612 (55%) who underwent ophthalmic examinations within 14 days after SAB onset were analyzed. Of those 612 patients, 56 (9% [95% confidence interval [CI], 7 to 12%]) had ocular involvement, including 15 (2.5%) with endophthalmitis and 41 (6.7%) with chorioretinitis. In a multivariate analysis, infective endocarditis (adjusted odds ratio [aOR], 5.74 [95% CI, 2.25 to 14.64]) and metastatic infection (aOR, 2.38 [95% CI, 1.29 to 4.39]) were independent risk factors for ocular involvement. Of the 47 patients with ocular involvement who could communicate, only 17 (36%) had visual disturbances. Two-thirds of the patients with endophthalmitis (10/15 patients) were treated with intravitreal antibiotics combined with parenteral antibiotics, whereas all of the patients with chorioretinitis were treated only with systemic antibiotics. No patients became blind. Among 42 patients for whom follow-up assessments were available, the ocular lesions improved in 29 (69%) but remained the same in the others. Ocular involvement was independently associated with death within 30 days after SAB onset. Ocular involvement is not uncommon among patients with SAB. Routine ophthalmic examinations should be considered for patients with infective endocarditis or metastatic infections caused by SAB.

One Year Retrospective Study of Ocular Infection in a Tertiary Care Hospital from Timisoara

2018 ◽  
Vol 69 (10) ◽  
pp. 2910-2912
Author(s):  
Iulia Cristina Bagiu ◽  
Delia Ioana Horhat ◽  
Simona Popescu ◽  
Florin George Horhat ◽  
Ciprian Pilut ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Staphylococcus Epidermidis ◽  
Care Center ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Ocular Infection ◽  
Care Hospital ◽  
Exclusion Criteria ◽  
Ocular Infections ◽  
Department Of Ophthalmology

Eye is the most important sensory organ concerned with the perception of vision. Ocular infections are one of the common diseases of the eye. Ocular infections as blepharitis, conjunctivitis, canaliculitis, dacryocystitis, keratitis, scleritis, orbital cellulitis, endophthalmitis, panophthalmitis and other infections which are responsible for increased incidence of morbidity and blindness worldwide, their morbidity vary from self-limiting trivial infection to sight threatening infection. To identify the bacterial profile of ocular infections in patients attending Ophthalmology Department. After clinical diagnosis of ocular infection made by Ophthalmologist, specimens were collected with the help of Ophthalmologist. Samples like eyelid swab, pus from dacryocystitis, corneal scrapings, corneal swab, and tissue specimens from 189 patients attending Ophthalmology Department were analyzed from 01.01.2014 to 01.01.2015. Using predefined inclusion and exclusion criteria, samples were collected according to the standard protocol. Inclusion criteria: 1. Clinically diagnosed cases of ocular infections attending Outpatient Department and Inpatient Department of Ophthalmology, Tertiary Care Center from Timisoara 2. Patients not on antibiotics (systemic or either topical) will be included in the study. 3. Patients not responding to antibiotics. Exclusion criteria: 1. Non-infectious etiology of ocular diseases. The material was examined Gram staining. The specimens were cultured on sheep�s blood agar, Chocolate agar and MacConkey agar, Chapman agar, Sabouraud dextrose agar. Drug susceptibility was tested using disc diffusion method (Kirby Bauer).The most common bacterial pathogen isolated were Staphylococcus aureus (29.7%) followed by Staphylococcus epidermidis (22.1%), other organisms isolated are Streptococcus pneumonia (17.9%), Klebsiella spp. (6.3%), Escherichia coli (4.7%), Pseudomonas aeruginosa (3.4%). Among the opportunistic pathogens, Staphylococcus epidermidis, (22.1%) were the most common isolate followed by Staphylococcus saprophyticus (0.45%). Bacterial isolates were highly susceptible to Vancomycin (100%), Gentamicin (92.1%) among Gram positive organisms. The Gram negative organisms are highly susceptible to Tobramycin (95.4%) and Imipenem (87.9%). The study suggests that Staphylococcus aureus and Staphylococcus epidermidis are the most common etiological agents of Ocular infections. Most of the strains were sensitive to Vancomycin and Tobramycin. Persistent efforts should be put for continuous surveillance and epidemiological characterization which are imperative to treat and prevent morbidity and blindness of population at risk.

Risk Factors for Nosocomial Infective Endocarditis in Patients with Methicillin-Resistant Staphylococcus Aureus Bacteremia

2005 ◽  
Vol 26 (7) ◽  
pp. 654-657 ◽  
Author(s):  
Ron-Bin Hsu
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Liver Disease ◽  
Infective Endocarditis ◽  
Chronic Liver Disease ◽  
Tertiary Care ◽  
Chronic Liver ◽  
Control Group ◽  
Care Hospital ◽  
Methicillin Resistant

AbstractBackground and Objective:Nosocomial infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are increasing. Only a few studies of MRSA infective endocarditis have been conducted, and none have reported its risk factors. We sought to determine the host-related risk factors for infective endocarditis in patients with nosocomial MRSA bacteremia.Setting:A 2,000-bed, university-affiliated, tertiary-care hospital.Patients:Thirty-one patients with nosocomial MRSA infective endocarditis between October 1996 and May 2003.Design:A retrospective chart review was conducted. Data were compared with those from a control group of patients with nosocomial MRSA bacteremia. Logistic regression was used to identify independent risk factors for nosocomial infective endocarditis.Results:Compared with patients who had nosocomial MRSA bacteremia and no infective endocarditis, patients who had infective endocarditis had a higher incidence of chronic liver disease and a lower incidence of immunodeficiency. The risk of developing infective endocarditis was approximately 10% for patients with nosocomial MRSA bacteremia.Conclusion:Patients with MRSA bacteremia and underlying chronic liver disease were prone to infective endocarditis. (Infect Control Hosp Epidemiol 2005;26:654-657)

scholarly journals Is Cefazolin Inferior to Nafcillin for Treatment of Methicillin-Susceptible Staphylococcus aureus Bacteremia?

2011 ◽  
Vol 55 (11) ◽  
pp. 5122-5126 ◽  
Author(s):  
Shinwon Lee ◽  
Pyoeng Gyun Choe ◽  
Kyoung-Ho Song ◽  
Sang-Won Park ◽  
Hong Bin Kim ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Treatment Failure ◽  
Propensity Scores ◽  
Tertiary Care ◽  
Care Hospital ◽  
Clinical Failure ◽  
Content Type ◽  
Staphylococcus Aureus Bacteremia ◽  
Matched Case ◽  
Control Study

ABSTRACTAbout 20% of methicillin-susceptibleStaphylococcus aureus(MSSA) isolates have a substantial inoculum effect with cefazolin, suggesting that cefazolin treatment may be associated with clinical failure for serious MSSA infections. There are no well-matched controlled studies comparing cefazolin with nafcillin for the treatment of MSSA bacteremia. A retrospective propensity-score-matched case-control study was performed from 2004 to 2009 in a tertiary care hospital where nafcillin was unavailable from August 2004 to August 2006. The cefazolin group (n= 49) included MSSA-bacteremic patients treated with cefazolin during the period of nafcillin unavailability, while the nafcillin group (n= 84) comprised those treated with nafcillin. Treatment failure was defined as a composite outcome of a change of antibiotics due to clinical failure, relapse, and mortality. Of 133 patients, 41 patients from each group were matched by propensity scores. There were no significant differences in baseline characteristics between the matched groups. The treatment failure rates were not significantly different at 4 or 12 weeks (10% [4/41] versus 10% [4/41] at 4 weeks [P> 0.99] and 15% [6/41] versus 15% [6/41] at 12 weeks [P> 0.99]). Cefazolin treatment was interrupted less frequently than nafcillin treatment due to drug adverse events (0% versus 17%;P= 0.02). Cefazolin had clinical efficacy similar to that of nafcillin and was more tolerable than nafcillin for the treatment of MSSA bacteremia.

scholarly journals A prospective study on risk factors for development of surgical site infections at a tertiary care hospital: a two years study

2018 ◽  
Vol 5 (2) ◽  
pp. 460
Author(s):  
Vakamudi Prakash ◽  
Ramalinga Reddy Rachamalli ◽  
Jithendra Kandati ◽  
Sreeram Satish
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Nosocomial Infections ◽  
Antibiotic Susceptibility ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Care Hospital ◽  
Multiple Factors ◽  
The Common

Background: Surgical site infections (SSI) are the second most common Nosocomial infections after urinary tract infections accounting to 20-25% of Nosocomial infections worldwide. Based on the depth of the infections, SSI is classified by CDC as superficial incisional, deep incisional and organ/space. The development of SSI is dependent upon multiple factors like class of wound, immune status, type of surgery, type of anesthesia; surgical techniques etc and are interplay of multiple factors. Objective of the present study was conducted in identifying the predictors, risk factors and incidence rates of SSI at a tertiary care hospital. The study also identifies the causative bacterial pathogens and their antibiotic susceptibility patternMethods: A prospective cross-sectional study was conducted for a period of two years by department of general surgery involving all patients who underwent surgery, and pre-operative, intra operative and risk factors of the cases were collected using standardized data collection form. Specimens from the infected wounds were collected and processed for isolation of pathogens. Antibiotic susceptibility of pathogens was done using standard guidelines.Results: The incidence of SSI in present study was 25.34% with 81.58% superficial SSI and 18.42% deep SSI. Laparotomy was the common procedure and 63.2% of cases were females and 41-60 years was the most common age group. Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli were the common pathogens and were sensitive to carbapenems, vancomycin and linezolid. Significant association was observed with presence of pre-morbid analysis, presence of drain, use of povidone iodine alone and development of SSI.Conclusions: In present study the incidence of SSI was significantly high in this hospital and associated with premorbid illness, duration of surgery, presence of drain and use of drain at site of surgery. Staphylococcus aureus was the common pathogen and incidence of MRSA is higher than many other reports. A continuous monitoring and surveillance of patients with a predefined protocol will help in early identification of cases with risk of development of SSI. A feedback of appropriate data to surgeons is highly recommended to reduce the SSI rate in developing countries.

scholarly journals agrDysfunction Affects Staphylococcal Cassette ChromosomemecType-Dependent Clinical Outcomes in Methicillin-Resistant Staphylococcus aureus Bacteremia

2015 ◽  
Vol 59 (6) ◽  
pp. 3125-3132 ◽  
Author(s):  
Chang Kyung Kang ◽  
Jeong Eun Cho ◽  
Yoon Jeong Choi ◽  
Younghee Jung ◽  
Nak-Hyun Kim ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
South Korea ◽  
Clinical Outcomes ◽  
Tertiary Care ◽  
High Rate ◽  
Care Hospital ◽  
Virulence Determinants ◽  
Methicillin Resistant ◽  
Content Type ◽  
Type Iv

ABSTRACTStaphylococcal cassette chromosomemecelement (SCCmec) type-dependent clinical outcomes may vary due to geographical variation in the presence of virulence determinants. We compared the microbiological factors and mortality attributed to methicillin-resistantStaphylococcus aureus(MRSA) bacteremia between SCCmectypes II/III and type IV. All episodes of MRSA bacteremia in a tertiary-care hospital (South Korea) over a 4.5-year period were reviewed. We studied the microbiological factors associated with all blood MRSA isolates, includingspatype,agrtype,agrdysfunction, and the genes for Panton-Valentine leukocidin (PVL) and phenol-soluble modulin (PSM)-mec, in addition to SCCmectype. Of 195 cases, 137 involved SCCmectypes II/III, and 58 involved type IV. The mortality attributed to MRSA bacteremia was less frequent among the SCCmectype IV (5/58) than that among types II/III (39/137,P= 0.002). This difference remained significant when adjusted for clinical factors (adjusted odds ratio [aOR], 0.14; 95% confidence interval [CI], 0.04 to 0.49;P= 0.002). Of the microbiological factors tested,agrdysfunction was the only significant factor that showed different positivity between the SCCmectypes, and it was independently associated with MRSA bacteremia-attributed mortality (aOR, 4.71; 95% CI, 1.72 to 12.92;P= 0.003). SCCmectype IV is associated with lower MRSA bacteremia-attributed mortality than are types II/III, which might be explained by the high rate ofagrdysfunction in SCCmectypes II/III in South Korea.

scholarly journals Reduced Vancomycin Susceptibility of Methicillin-Susceptible Staphylococcus aureus Has No Significant Impact on Mortality but Results in an Increase in Complicated Infection

2017 ◽  
Vol 61 (7) ◽  
Author(s):  
Sean B. Sullivan ◽  
Eloise D. Austin ◽  
Stephania Stump ◽  
Barun Mathema ◽  
Susan Whittier ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Care Hospital ◽  
Content Type ◽  
Logistic Regression Models ◽  
Potential Marker ◽  
Vancomycin Mics ◽  
Comorbidity Index ◽  
The Impact

ABSTRACT Methicillin-susceptible Staphylococcus aureus (MSSA) bloodstream infections (BSIs) often lead to severe complications despite the availability of effective antibiotics. It remains unclear whether elevated vancomycin MICs are associated with worse outcomes. We conducted a 2-year retrospective cohort study (n = 252) of patients with MSSA BSIs at a tertiary care hospital. We defined reduced vancomycin susceptibility (RVS) as a Microscan MIC of 2 mg/liter. All strains were genotyped (spa) and assessed for agr functionality. Multivariable logistic regression models were used to examine the impact of RVS phenotype and strain genotype on 30-day all-cause mortality and complicated bacteremia (metastatic spread, endovascular infection, or duration ≥3 days). One-third of patients (84/252) were infected with RVS isolates. RVS Infections were more frequently associated with metastatic or embolic sites of infection (36% versus 17%, P < 0.001), and endovascular infection (26% versus 12%, P = 0.004). These infections occurred more often in patients with fewer underlying comorbidities (Charlson comorbidity index of ≥3 [73% versus 88%, P = 0.002]). Genotyping identified 127 spa-types and 14 Spa-clonal complexes (Spa-CCs). Spa-CC002 and Spa-CC008 were more likely to exhibit the RVS phenotype versus other Spa-CCs (OR = 2.2, P < 0.01). The RVS phenotype was not significantly associated with 30-day mortality; however, it was associated with complicated bacteremia (adjusted odds ratio of 2.35 [range, 1.26 to 4.37]; P = 0.007) in adjusted analyses. The association of RVS strains with complicated infection and fewer underlying comorbidities suggests the phenotype as a potential marker of strain virulence in MSSA BSIs. The RVS phenotype itself was not a significant predictor of mortality in this patient cohort. Further studies are necessary to explore this host-pathogen relationship.

Methicillin Resistance and Risk Factors for Embolism inStaphylococcus aureusInfective Endocarditis

2007 ◽  
Vol 28 (7) ◽  
pp. 860-866 ◽  
Author(s):  
Ron-Bin Hsu ◽  
Fang-Yue Lin
Keyword(s):  
Risk Factors ◽  
Infective Endocarditis ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Neurological Involvement ◽  
Hospital Death ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Independent Risk Factors

Objective.Infective endocarditis caused byStaphylococcus aureusis an ominous prognosis associated with a high prevalence of embolic episodes and neurological involvement. Whether methicillin resistance decreases the risk of embolism in infective endocarditis is unclear. We sought to assess the association between methicillin resistance and risk factors for embolism in S.aureusinfective endocarditis.Design.Retrospective chart review. Data from patients with infective endocarditis due to methicillin-resistantS. aureus werecompared with data from patients with endocarditis due to methicillin-susceptibleS. aureus.Logistic regression was used to identify independent risk factors for embolism.Setting.A 2,000-bed, university-affiliated tertiary care hospital.Patients.Between 1995 and 2005, 123 patients withS. aureusinfective endocarditis were included in the study. There were 74 male patients and 49 female patients, with a median age of 54 years (range, 0-89 years).Results.Of 123 infections, 30 (24%) were nosocomial infections, and 14 (11%) were prosthetic valve infections. Of 123S. aureusisolates, 48 (39%) were methicillin resistant. In total, embolism occurred in 45 (37%) of these patients: pulmonary embolism in 22 (18%), cerebral embolism in 21 (17%), and peripheral embolism in 6 (5%). The independent risk factors for an embolism were injection drug use, presence of a cardiac vegetation with a size of 10 mm or greater, and absence of nosocomial infection. For 83 patients with aortic or mitral infective endocarditis, independent risk factors for an embolism were the presence of a cardiac vegetation with a size of 10 mm or greater and endocarditis due to methicillin-susceptibleS. aureus.Overall, in-hospital death occurred for 32 (26%) of 123 Patients. Methicillin-resistant infection was not an independent risk factor for death.Conclusions.Methicillin-resistant S.aureusinfection was associated with decreased risk of embolism in left-side endocarditis, but was not associated with in-hospital death.

scholarly journals Periprosthetic Joint Infections as a Consequence of Bacteremia

2019 ◽  
Vol 6 (6) ◽  
Author(s):  
Meeri Honkanen ◽  
Esa Jämsen ◽  
Matti Karppelin ◽  
Reetta Huttunen ◽  
Antti Eskelinen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Joint Replacement ◽  
Joint Infection ◽  
Tertiary Care ◽  
Care Hospital ◽  
Hip Joint Replacement ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Staphylococcus Aureus Bacteremia

Abstract Background The risk for developing a periprosthetic joint infection (PJI) during bacteremia is unclear, except for Staphylococcus aureus bacteremia. The aim of this study was to examine the risk for developing a PJI during bacteremia and to identify possible risk factors leading to it. Methods Patients with a primary knee or hip joint replacement performed in a tertiary care hospital between September 2002 and December 2013 were identified (n = 14 378) and followed up until December 2014. Positive blood culture results during the study period and PJIs were recorded. PJIs associated with an episode of bacteremia were identified and confirmed from patient records. Potential risk factors for PJI among those with bacteremia were examined using univariate logistic regression. Results A total of 542 (3.8%) patients had at least 1 episode of bacteremia. Seven percent (47/643) of the bacteremias resulted in a PJI. Development of a PJI was most common for Staphylococcus aureus (21% of bacteremias led to a PJI) and beta-hemolytic streptococci (21%), whereas it was rare for gram-negative bacteria (1.3%). Having ≥2 bacteremias during the study period increased the risk for developing a PJI (odds ratio, 2.29; 95% confidence interval, 1.17–4.50). The risk for developing a PJI was highest for bacteremias occurring within a year of previous surgery. Chronic comorbidities did not affect the risk for PJI during bacteremia. Conclusions The development of a PJI during bacteremia depends on the pathogen causing the bacteremia and the timing of bacteremia with respect to previous joint replacement surgery. However, significant patient-related risk factors for PJI during bacteremia could not be found.

scholarly journals Accessory Gene Regulator (agr) Dysfunction in Staphylococcus aureus Bloodstream Isolates from South Korean Patients

2012 ◽  
Vol 57 (3) ◽  
pp. 1509-1512 ◽  
Author(s):  
Yong Pil Chong ◽  
Eun Sil Kim ◽  
Su-Jin Park ◽  
Ki-Ho Park ◽  
Tark Kim ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Care Hospital ◽  
Accessory Gene ◽  
Content Type ◽  
South Korean ◽  
Accessory Gene Regulator ◽  
Clonal Spread ◽  
Hospital Acquired

ABSTRACTWe describe the genetic and microbiological characteristics of methicillin-resistantStaphylococcus aureus(MRSA) bloodstream isolates withagrdysfunction from a tertiary-care hospital in Korea. Of these, ST5-SCCmectype II-agrgroup II MRSA isolates, which are known to be prevalent in hospital-acquired infections in Korea, were the most abundant, because of the clonal spread of a specificagr-defective lineage. This finding suggests that the loss ofagrfunction may confer a potential advantage in a hospital setting. Clonal spread of a specific defective-agrstrain was not observed among community-associated MRSA or methicillin-susceptibleS. aureusclones, regardless of community or hospital acquisition of infection.agr-defective clones, including ST5 and ST239 MRSA, were enriched for heteroresistant vancomycin-intermediateS. aureus.

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