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Risk factors for persistent carriage of methicillin-resistant Staphylococcus aureus.
Clin Infect Dis. 2000 Dec; 31(6):1380-5.CI

Abstract

We determined risk factors associated with persistent carriage of methicillin-resistant Staphylococcus aureus (MRSA) among 102 patients enrolled in a double-blind, placebo-controlled trial of nasally administered mupirocin ointment. MRSA decolonization was unsuccessful in 77 (79%) of 98 patients who met the criteria for evaluation. By univariate analysis, 4 variables were found to be associated with persistent MRSA colonization (P < .1 for all 4): absence of mupirocin treatment, previous fluoroquinolone therapy, > or = 2 MRSA-positive body sites, and low-level mupirocin resistance. After multivariable Cox proportional hazards modeling, the presence of > or = 2 positive body sites (adjusted hazard ratio [AHR], 1.7; 95% confidence interval [CI], 1.0-2.9) and previous receipt of a fluoroquinolone (AHR, 1.8; 95% CI, 1.0-3.3) were independently associated with MRSA persistence, whereas nasal mupirocin tended to confer protection (AHR, 0.6; 95% CI, 0.4-1.0). Low-level mupirocin resistance was observed in 9 genotypically different MRSA strains and was not independently associated with chronic MRSA carriage (AHR, 1.5; 95% CI, 0.9-2.5). Our findings suggest that multisite MRSA carriage and previous receipt of a fluoroquinolone are independent risk factors for persistent MRSA colonization.

Authors+Show Affiliations

Infection Control Program, University Hospitals of Geneva, Geneva, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11096006

Citation

Harbarth, S, et al. "Risk Factors for Persistent Carriage of Methicillin-resistant Staphylococcus Aureus." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 31, no. 6, 2000, pp. 1380-5.
Harbarth S, Liassine N, Dharan S, et al. Risk factors for persistent carriage of methicillin-resistant Staphylococcus aureus. Clin Infect Dis. 2000;31(6):1380-5.
Harbarth, S., Liassine, N., Dharan, S., Herrault, P., Auckenthaler, R., & Pittet, D. (2000). Risk factors for persistent carriage of methicillin-resistant Staphylococcus aureus. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 31(6), 1380-5.
Harbarth S, et al. Risk Factors for Persistent Carriage of Methicillin-resistant Staphylococcus Aureus. Clin Infect Dis. 2000;31(6):1380-5. PubMed PMID: 11096006.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for persistent carriage of methicillin-resistant Staphylococcus aureus. AU - Harbarth,S, AU - Liassine,N, AU - Dharan,S, AU - Herrault,P, AU - Auckenthaler,R, AU - Pittet,D, Y1 - 2000/11/10/ PY - 2000/01/24/received PY - 2000/05/08/revised PY - 2000/11/30/pubmed PY - 2001/5/1/medline PY - 2000/11/30/entrez SP - 1380 EP - 5 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 31 IS - 6 N2 - We determined risk factors associated with persistent carriage of methicillin-resistant Staphylococcus aureus (MRSA) among 102 patients enrolled in a double-blind, placebo-controlled trial of nasally administered mupirocin ointment. MRSA decolonization was unsuccessful in 77 (79%) of 98 patients who met the criteria for evaluation. By univariate analysis, 4 variables were found to be associated with persistent MRSA colonization (P < .1 for all 4): absence of mupirocin treatment, previous fluoroquinolone therapy, > or = 2 MRSA-positive body sites, and low-level mupirocin resistance. After multivariable Cox proportional hazards modeling, the presence of > or = 2 positive body sites (adjusted hazard ratio [AHR], 1.7; 95% confidence interval [CI], 1.0-2.9) and previous receipt of a fluoroquinolone (AHR, 1.8; 95% CI, 1.0-3.3) were independently associated with MRSA persistence, whereas nasal mupirocin tended to confer protection (AHR, 0.6; 95% CI, 0.4-1.0). Low-level mupirocin resistance was observed in 9 genotypically different MRSA strains and was not independently associated with chronic MRSA carriage (AHR, 1.5; 95% CI, 0.9-2.5). Our findings suggest that multisite MRSA carriage and previous receipt of a fluoroquinolone are independent risk factors for persistent MRSA colonization. SN - 1058-4838 UR - https://www.unboundmedicine.com/medline/citation/11096006/Risk_factors_for_persistent_carriage_of_methicillin_resistant_Staphylococcus_aureus_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/317484 DB - PRIME DP - Unbound Medicine ER -