Epidemiology and Outcome of Pneumonia Caused by Methicillin-Resistant Staphylococcus aureus (MRSA) in Canadian Hospitals
| Autor: | Stephanie Smith, Victoria Williams, Geoff Taylor, Andrew E. Simor, Shariq Haider, Manal Tadros, Allison McGeer, Kevin Katz, Michael John, Jeff Powis, Kathryn N. Suh, Harris Iacovides, Brenda L. Coleman, Nancy Laffin, Christine Watt, Ethan Rubinstein, Christine H. Lee, Shelly A. McNeil, Lynn Johnston |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Methicillin-Resistant Staphylococcus aureus medicine.medical_specialty Canada lcsh:Medicine Comorbidity medicine.disease_cause Young Adult Internal medicine Cause of Death Epidemiology Pneumonia Staphylococcal medicine Humans Public Health Surveillance Prospective Studies Intensive care medicine lcsh:Science Etest Aged Aged 80 and over Cross Infection Multidisciplinary business.industry Incidence (epidemiology) Mortality rate lcsh:R biochemical phenomena metabolism and nutrition Middle Aged medicine.disease bacterial infections and mycoses Methicillin-resistant Staphylococcus aureus Patient Outcome Assessment Pneumonia Bacteremia Vancomycin lcsh:Q Female business medicine.drug Research Article |
| Zdroj: | PLoS ONE PLoS ONE, Vol 8, Iss 9, p e75171 (2013) |
| ISSN: | 1932-6203 |
| Popis: | Background MRSA remains a leading cause of hospital-acquired (HAP) and healthcare-associated pneumonia (HCAP). We describe the epidemiology and outcome of MRSA pneumonia in Canadian hospitals, and identify factors contributing to mortality. Methods Prospective surveillance for MRSA pneumonia in adults was done for one year (2011) in 11 Canadian hospitals. Standard criteria for MRSA HAP, HCAP, ventilator-associated pneumonia (VAP), and community-acquired pneumonia (CAP) were used to identify cases. MRSA isolates underwent antimicrobial susceptibility testing, and were characterized by pulsed-field gel electrophoresis (PFGE) and Panton-Valentine leukocidin (PVL) gene detection. The primary outcome was all-cause mortality at 30 days. A multivariable analysis was done to examine the association between various host and microbial factors and mortality. Results A total of 161 patients with MRSA pneumonia were identified: 90 (56%) with HAP, 26 (16%) HCAP, and 45 (28%) CAP; 23 (14%) patients had VAP. The mean (± SD) incidence of MRSA HAP was 0.32 (± 0.26) per 10,000 patient-days, and of MRSA VAP was 0.30 (± 0.5) per 1,000 ventilator-days. The 30-day all-cause mortality was 28.0%. In multivariable analysis, variables associated with mortality were the presence of multiorgan failure (OR 8.1; 95% CI 2.5-26.0), and infection with an isolate with reduced susceptibility to vancomycin (OR 2.5, 95% CI 1.0-6.3). Conclusions MRSA pneumonia is associated with significant mortality. Severity of disease at presentation, and infection caused by an isolate with elevated MIC to vancomcyin are associated with increased mortality. Additional studies are required to better understand the impact of host and microbial variables on outcome. |
| Databáze: | OpenAIRE |
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