Methicillin-resistant Staphylococcus aureus bacteraemia diagnosed at hospital admission: distinguishing between community-acquired versus healthcare-associated strains
| Autor: | P C De Girolami, Evelina Tacconelli, E M C DAgata, Lata Venkataraman |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Male
Microbiology (medical) Staphylococcus aureus medicine.medical_specialty Pediatrics Micrococcaceae medicine.medical_treatment Bacteremia Microbial Sensitivity Tests medicine.disease_cause Risk Factors Internal medicine Epidemiology medicine Humans Pharmacology (medical) Aged Pharmacology Cross Infection biology business.industry Middle Aged Staphylococcal Infections biochemical phenomena metabolism and nutrition bacterial infections and mycoses medicine.disease biology.organism_classification Methicillin-resistant Staphylococcus aureus Community-Acquired Infections Infectious Diseases Cellulitis Hospital admission Female Methicillin Resistance business Central venous catheter Boston |
| Zdroj: | Journal of Antimicrobial Chemotherapy. 53:474-479 |
| ISSN: | 1460-2091 |
| DOI: | 10.1093/jac/dkh107 |
| Popis: | BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) infections diagnosed at hospital admission are often referred to as community-acquired. This designation may include MRSA strains previously acquired in a healthcare setting (healthcare-associated) as well as those that have emerged from community-based S. aureus strains. METHODS To understand further the epidemiology of MRSA from the community, a case-control study was performed. During 1997-2002, 254 patients with and without MRSA bacteraemia at hospital admission were studied. RESULTS All patients with MRSA bacteraemia in the first 24 h of hospital admission had a recent exposure to a healthcare setting: true community-acquired MRSA was not detected. Independent risk factors for healthcare-associated MRSA bacteraemia, defined as MRSA bacteraemia in the first 24 h of hospital admission among patients with a recent exposure to a healthcare setting or intervention, included previous MRSA infection or colonization (OR = 17, P < 0.001), cellulitis (OR = 4, P = 0.006), presence of a central venous catheter (OR = 3, P < 0.001) and skin ulcers (OR = 3, P = 0.007). CONCLUSIONS In this study, MRSA bacteraemia diagnosed in the first 24 h of hospital admission represented healthcare-associated MRSA strains and not true community-acquired strains. The clinical characteristics associated with healthcare-associated MRSA bacteraemia can assist clinicians in targeting measures to prevent cross-transmission and may help to streamline empirical vancomycin therapy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|