Long-term methicillin-resistant Staphylococcus aureus bacteremia persisting for more than 2 weeks: risk factors and outcomes
| Autor: | Sang-Oh Lee, Yong Pil Chong, Sung-Han Kim, Ki-Ho Park, Yu-Mi Lee, Yang Soo Kim, Sang-Ho Choi, Jun Hee Woo, Min Jeong Kim, Mi Young Kim, Eun Sil Kim, Yewon Eom |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Methicillin-Resistant Staphylococcus aureus 0301 basic medicine Microbiology (medical) medicine.medical_specialty Time Factors Meticillin medicine.drug_class 030106 microbiology Antibiotics Bacteremia medicine.disease_cause Tertiary Care Centers 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Odds Ratio medicine Humans Hospital Mortality Prospective Studies 030212 general & internal medicine Aged business.industry Mortality rate Osteomyelitis General Medicine Odds ratio Middle Aged Staphylococcal Infections bacterial infections and mycoses medicine.disease Methicillin-resistant Staphylococcus aureus Anti-Bacterial Agents Infectious Diseases Staphylococcus aureus Case-Control Studies Catheter-Related Infections Female business medicine.drug |
| Zdroj: | European Journal of Clinical Microbiology & Infectious Diseases. 39:773-781 |
| ISSN: | 1435-4373 0934-9723 |
| DOI: | 10.1007/s10096-019-03795-6 |
| Popis: | The clinical significance of long-term methicillin-resistant Staphylococcus aureus (MRSA) bacteremia remains unclear. We evaluated the clinical, microbiological characteristics, and clinical outcomes of long-term MRSA bacteremia. A nested case-control study was conducted in a prospective cohort of adult patients with MRSA bacteremia at a tertiary hospital between August 2008 and December 2017. Patients with long-term MRSA bacteremia (≥ 14 days) were compared with control patients, defined as having bacteremia that resolved in less than 3 days. The following variables were documented: heteroresistance phenotype, genotypes, agr dysfunction, and the presence of 41 virulence genes in isolates. Of the total 890 patients studied, 69 patients (7.8%) exhibited long-term MRSA bacteremia and 599 (67.3%) exhibited resolving bacteremia. The most common sources of long-term bacteremia were central venous catheter–related infection (39%) and osteomyelitis (19%). Independent risk factors for long-term MRSA bacteremia included male sex (adjusted odds ratio [aOR] = 2.43), community-acquired bacteremia (aOR = 2.93), the presence of a prosthetic device (aOR = 3.40), and osteomyelitis (aOR = 7.98). Metastatic infections developed more frequently in patients with long-term bacteremia than in those with resolving bacteremia (56.5% vs. 8.0%; P |
| Databáze: | OpenAIRE |
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