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Methicillin-resistant Staphylococcus aureus bacteraemia diagnosed at hospital admission: distinguishing between community-acquired versus healthcare-associated strains.
J Antimicrob Chemother 2004; 53(3):474-9JA

Abstract

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.

Authors+Show Affiliations

Division of Infectious Diseases and Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA. etaccone@bidmc.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14762054

Citation

Tacconelli, E, et al. "Methicillin-resistant Staphylococcus Aureus Bacteraemia Diagnosed at Hospital Admission: Distinguishing Between Community-acquired Versus Healthcare-associated Strains." The Journal of Antimicrobial Chemotherapy, vol. 53, no. 3, 2004, pp. 474-9.
Tacconelli E, Venkataraman L, De Girolami PC, et al. Methicillin-resistant Staphylococcus aureus bacteraemia diagnosed at hospital admission: distinguishing between community-acquired versus healthcare-associated strains. J Antimicrob Chemother. 2004;53(3):474-9.
Tacconelli, E., Venkataraman, L., De Girolami, P. C., & DAgata, E. M. (2004). Methicillin-resistant Staphylococcus aureus bacteraemia diagnosed at hospital admission: distinguishing between community-acquired versus healthcare-associated strains. The Journal of Antimicrobial Chemotherapy, 53(3), pp. 474-9.
Tacconelli E, et al. Methicillin-resistant Staphylococcus Aureus Bacteraemia Diagnosed at Hospital Admission: Distinguishing Between Community-acquired Versus Healthcare-associated Strains. J Antimicrob Chemother. 2004;53(3):474-9. PubMed PMID: 14762054.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Methicillin-resistant Staphylococcus aureus bacteraemia diagnosed at hospital admission: distinguishing between community-acquired versus healthcare-associated strains. AU - Tacconelli,E, AU - Venkataraman,L, AU - De Girolami,P C, AU - DAgata,E M C, Y1 - 2004/02/04/ PY - 2004/2/6/pubmed PY - 2004/5/12/medline PY - 2004/2/6/entrez SP - 474 EP - 9 JF - The Journal of antimicrobial chemotherapy JO - J. Antimicrob. Chemother. VL - 53 IS - 3 N2 - 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. SN - 0305-7453 UR - https://www.unboundmedicine.com/medline/citation/14762054/Methicillin_resistant_Staphylococcus_aureus_bacteraemia_diagnosed_at_hospital_admission:_distinguishing_between_community_acquired_versus_healthcare_associated_strains_ L2 - https://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dkh107 DB - PRIME DP - Unbound Medicine ER -