1. Epidemiology of bloodstream infections caused by methicillin-resistant Staphylococcus aureus at a tertiary care hospital in New York
- Author
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Ambreen Khalil, Halim El Hage, Mazen Zaarour, Rita Obeid, Hanine El Haddad, and Mohamad Yasmin
- Subjects
Adult ,Male ,Methicillin-Resistant Staphylococcus aureus ,0301 basic medicine ,Catheterization, Central Venous ,medicine.medical_specialty ,Pediatrics ,Adolescent ,Epidemiology ,medicine.medical_treatment ,030106 microbiology ,New York ,Bacteremia ,Staphylococcal infections ,medicine.disease_cause ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Humans ,Medicine ,030212 general & internal medicine ,Renal Insufficiency, Chronic ,Risk factor ,Aged ,Aged, 80 and over ,Cross Infection ,Tertiary Healthcare ,business.industry ,Health Policy ,Public Health, Environmental and Occupational Health ,Odds ratio ,Length of Stay ,Middle Aged ,Staphylococcal Infections ,bacterial infections and mycoses ,medicine.disease ,Methicillin-resistant Staphylococcus aureus ,Community-Acquired Infections ,Infectious Diseases ,Staphylococcus aureus ,Case-Control Studies ,Female ,Methicillin Resistance ,business ,human activities ,Central venous catheter - Abstract
Background In the United States, bloodstream infections (BSIs) are predominated by Staphylococcus aureus . The proportion of community-acquired methicillin-resistant S aureus (MRSA) BSI is on the rise. The goal of this study is to explore the epidemiology of BSI caused by S aureus within Staten Island, New York. Methods This is a case-case-control study from April 2012-October 2014. Cases were comprised of patients with BSI secondary to MRSA and methicillin-sensitive S aureus (MSSA). The control group contained patients who were hospitalized during the same time period as cases but did not develop infections during their stay. Two multivariable models compared each group of cases with the uninfected controls. Results A total of 354 patients were analyzed. Infections were community acquired in 76% of cases. The major source of BSI was skin-related infections (n = 76). The first multivariable model showed that recent central venous catheter placement was an independent infection risk factor (odds ratio [OR] = 80.7; 95% confidence interval [CI], 2.2-3,014.1). In the second model, prior hospital stay >3 days (OR = 4.1; 95% CI, 1.5-5.7) and chronic kidney disease (OR = 3.0; 95% CI, 1.01-9.2) were uniquely associated with MSSA. Persistent bacteremia, recurrence, and other hospital-acquired infections were more likely with MRSA BSI than MSSA BSI. Conclusion Most infections were community acquired. The presence of a central venous catheter constituted a robust independent risk factor for MRSA BSI. Patients with MRSA BSI suffered worse outcomes than those with MSSA BSI.
- Published
- 2016