Clinical characteristics, treatment and outcomes of MRSA bacteraemia in the elderly
| Autor: | Cristina Fernández, José Antonio Lepe, Elena Pérez-Nadales, José Ramón Blanco, A. Granados, J. Tapiol, Mariana Camoez, C. Padilla, Clara Natera, Esther Calbo, M.A. Goenaga, Guillermo Cuervo, J. Rodríguez-Baño, D. Fontanals, Margarita Salvadó, M. Pujol, Álvaro Pascual, A. Jover, Juan Pablo Horcajada, Elena Bereciartua, José Molina, María Ángeles Domínguez, Benito Almirante, Miguel Ángel Goenaga, Belén Padilla, J.P. Horcajada, Emilio Ojeda, María-Cruz Rodríguez, Irene Gracia-Ahufinger, José Antonio Martínez, Ana Arnaiz, Miquel Pujol, M. A. Morera, Fernando Rodríguez-López, María Lagarde, C. Martin, M.A. Domínguez, Francisco López-Medrano, Maria-Consol Garcia, J.M. Montejo, Fernando Chaves, Fernando Barcenilla, M. Xercavins, Javier Murillas, J A Martínez, Jesús Rodríguez-Baño, Enrique Ruiz de Gopegui, Natividad Benito, J. Torre-Cisneros, A. Arnáiz, M. Camoez, Milagro Montero, J. M. García-Arenzana, Nieves Larrosa, M. Á. von Wichmann, Vicente Pintado, René Unda Lara, B. Almirante, Oriol Gasch, Evelyn Shaw, José Miguel Montejo, E. Ruiz de Gopegui, José L. Hernández, Elena Loza, O. Gasch, E. Cercenado, J.A. Lepe, Luis Eduardo López-Cortés, Elena Espejo, Beatriz Mirelis, Carlos Dueñas, N. Benito, Francesc Marco, B. Padilla, I. Olarte, V. Pintado, G. García-Pardo, R. Sordé, F. López-Medrano |
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| Rok vydání: | 2015 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Male Methicillin-Resistant Staphylococcus aureus Pediatrics medicine.medical_specialty 030106 microbiology Bacteremia 03 medical and health sciences 0302 clinical medicine Older patients medicine Humans MRSA bacteraemia In patient 030212 general & internal medicine Prospective Studies Prospective cohort study Aged Aged 80 and over business.industry Age Factors Staphylococcal Infections bacterial infections and mycoses medicine.disease Comorbidity Hospitals Infectious Diseases Treatment Outcome Underlying disease Spain Cohort Female business Empiric therapy |
| Zdroj: | The Journal of infection. 72(3) |
| ISSN: | 1532-2742 |
| Popis: | To compare clinical and microbiological characteristics, treatment and outcomes of MRSA bacteraemia among elderly and younger patients.Prospective study conducted at 21 Spanish hospitals including patients with MRSA bacteraemia diagnosed between June/2008 and December/2009. Episodes diagnosed in patients aged 75 or more years old (≥75) were compared with the rest of them (75).Out of 579 episodes of MRSA bacteraemia, 231 (39.9%) occurred in patients ≥75. Comorbidity was significantly higher in older patients (Charlson score ≥4: 52.8 vs. 44%; p = .037) as was the severity of the underlying disease (McCabe ≥1: 61.9 vs. 43.4%; p.001). In this group the acquisition was more frequently health-care related (43.3 vs. 33.9%, p = .023), mostly from long-term care centers (12.1 vs. 3.7%, p.001). An unknown focus was more frequent among ≥75 (19.9 vs. 13.8%; p = .050) while severity at presentation was similar between groups (Pitt score ≥3: 31.2 vs. 27.6%; p = .352). The prevalence of vancomycin resistant isolates was similar between groups, as was the appropriateness of empirical antibiotic therapy. Early (EM) and overall mortality (OM) were significantly more frequent in the ≥75 group (EM: 12.1 vs. 6%; p = .010 OM: 42.9 vs. 23%; p.001). In multivariate analysis age ≥75 was an independent risk factor for overall mortality (aOR: 2.47, CI: 1.63-3.74; p.001).MRSA bacteraemia was frequent in patients aged ≥75 of our cohort. This group had higher comorbidity rates and the source of infection was more likely to be unknown. Although no differences were seen in severity or adequacy of empiric therapy, elderly patients showed a higher overall mortality. |
| Databáze: | OpenAIRE |
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