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Risk factors for mortality of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection: With investigation of the potential role of community-associated MRSA strains
- Source :
- Journal of Infection. 61:449-457
- Publication Year :
- 2010
- Publisher :
- Elsevier BV, 2010.
-
Abstract
- The difference in the outcomes of nosocomial bloodstream infection (BSI) caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strains and healthcare-associated MRSA (HA-MRSA) strains remains unclear.From January 1, 2006 to December 31, 2008, all adult patients hospitalized at National Taiwan University Hospital with nosocomial MRSA BSI were analyzed. Available MRSA isolates were submitted for subsequent microbiologic studies to determine whether they belonged to CA-MRSA strains.In total, 308 patients were enrolled and 253 MRSA isolates were available. Forty-seven isolates belonged to CA-MRSA strains. The all-cause mortality rates on Day 14 and Day 30 were 19.8% and 30.5%, respectively, and were not different between those caused by CA-MRSA and HA-MRSA strains. The independent risk factors for Day 14 mortality were septic shock, thrombocytopenia, and an inadequate serum trough level of vancomycin (p =0.0001, 0.0003, and 0.0381, respectively). Those for Day 30 mortality were septic shock, anemia, thrombocytopenia, presence of underlying malignancies, and MRSA isolates with a vancomycin minimum inhibitory concentration of 2 mg/L (p =0.0001, 0.0425, 0.0007, 0.0098, and 0.0012, respectively).The mortality rates of nosocomial MRSA BSI were not different between that caused by CA-MRSA and HA-MRSA strains.
- Subjects :
- Adult
DNA, Bacterial
Male
Methicillin-Resistant Staphylococcus aureus
Microbiology (medical)
Genotype
medicine.drug_class
Antibiotics
Taiwan
Bacteremia
Biology
medicine.disease_cause
Microbiology
Risk Factors
medicine
Humans
Risk factor
Aged
Aged, 80 and over
Cross Infection
Septic shock
Mortality rate
Middle Aged
Staphylococcal Infections
biochemical phenomena, metabolism, and nutrition
bacterial infections and mycoses
medicine.disease
Methicillin-resistant Staphylococcus aureus
Community-Acquired Infections
Infectious Diseases
Staphylococcus aureus
Vancomycin
Female
Multilocus Sequence Typing
medicine.drug
Subjects
Details
- ISSN :
- 01634453
- Volume :
- 61
- Database :
- OpenAIRE
- Journal :
- Journal of Infection
- Accession number :
- edsair.doi.dedup.....b4ab3bf7d1458d15c440a82e7bc6ca6d