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Increased mortality among elderly patients with meticillin-resistant Staphylococcus aureus bacteraemia.
J Hosp Infect 2006; 64(3):251-6JH

Abstract

Despite the high prevalence of meticillin-resistant Staphylococcus aureus (MRSA) infections among the elderly, outcomes of nosocomial MRSA bloodstream infections (BSI) for this patient population have not been fully examined. We performed a case-control study to compare outcomes of hospital-acquired MRSA BSI among patients >/=65 years of age (cases) with those younger than 65 years of age (controls). In a 430-bed tertiary-care teaching hospital, 100 hospitalized patients >/=18 years of age with S. aureus BSI were included in the study. Measurements obtained were: comorbidities, severity of illness at presentation, antibiotic therapy, haematogenous complications and mortality. Overall mortality was significantly higher among cases than controls [36% vs 12%; odds ratio (OR) 4.1, 95% confidence interval (CI) 1.4-14, P<0.01]. A pulmonary source was identified more frequently among elderly patients compared with younger controls (34% vs 16%; OR 2.7, 95%CI 1.1-8.1, P=0.04). On logistic regression, the following variables were independently associated with MRSA BSI among elderly patients: admission to a medical ward (OR 3.1, 95%CI 1.3-7.6, P=0.02), non-central-venous-catheter-related BSI (OR 3, 95%CI 1.2-7.6, P=0.02) and death (OR 3.7, 95%CI 1.3-11, P=0.02). Among patients who received vancomycin, more cases were treated with a reduced dose of vancomycin due to renal insufficiency compared with controls (64% vs 31%; OR 4, 95%CI 2-9, P=0.01). These data suggest that MRSA BSI is associated with significant mortality among the elderly population. Preventing MRSA acquisition among this patient population is of paramount importance.

Authors+Show Affiliations

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

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16978733

Citation

Tacconelli, E, et al. "Increased Mortality Among Elderly Patients With Meticillin-resistant Staphylococcus Aureus Bacteraemia." The Journal of Hospital Infection, vol. 64, no. 3, 2006, pp. 251-6.
Tacconelli E, Pop-Vicas AE, D'Agata EM. Increased mortality among elderly patients with meticillin-resistant Staphylococcus aureus bacteraemia. J Hosp Infect. 2006;64(3):251-6.
Tacconelli, E., Pop-Vicas, A. E., & D'Agata, E. M. (2006). Increased mortality among elderly patients with meticillin-resistant Staphylococcus aureus bacteraemia. The Journal of Hospital Infection, 64(3), pp. 251-6.
Tacconelli E, Pop-Vicas AE, D'Agata EM. Increased Mortality Among Elderly Patients With Meticillin-resistant Staphylococcus Aureus Bacteraemia. J Hosp Infect. 2006;64(3):251-6. PubMed PMID: 16978733.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased mortality among elderly patients with meticillin-resistant Staphylococcus aureus bacteraemia. AU - Tacconelli,E, AU - Pop-Vicas,A E, AU - D'Agata,E M C, Y1 - 2006/09/14/ PY - 2006/02/07/received PY - 2006/07/04/accepted PY - 2006/9/19/pubmed PY - 2006/12/21/medline PY - 2006/9/19/entrez SP - 251 EP - 6 JF - The Journal of hospital infection JO - J. Hosp. Infect. VL - 64 IS - 3 N2 - Despite the high prevalence of meticillin-resistant Staphylococcus aureus (MRSA) infections among the elderly, outcomes of nosocomial MRSA bloodstream infections (BSI) for this patient population have not been fully examined. We performed a case-control study to compare outcomes of hospital-acquired MRSA BSI among patients >/=65 years of age (cases) with those younger than 65 years of age (controls). In a 430-bed tertiary-care teaching hospital, 100 hospitalized patients >/=18 years of age with S. aureus BSI were included in the study. Measurements obtained were: comorbidities, severity of illness at presentation, antibiotic therapy, haematogenous complications and mortality. Overall mortality was significantly higher among cases than controls [36% vs 12%; odds ratio (OR) 4.1, 95% confidence interval (CI) 1.4-14, P<0.01]. A pulmonary source was identified more frequently among elderly patients compared with younger controls (34% vs 16%; OR 2.7, 95%CI 1.1-8.1, P=0.04). On logistic regression, the following variables were independently associated with MRSA BSI among elderly patients: admission to a medical ward (OR 3.1, 95%CI 1.3-7.6, P=0.02), non-central-venous-catheter-related BSI (OR 3, 95%CI 1.2-7.6, P=0.02) and death (OR 3.7, 95%CI 1.3-11, P=0.02). Among patients who received vancomycin, more cases were treated with a reduced dose of vancomycin due to renal insufficiency compared with controls (64% vs 31%; OR 4, 95%CI 2-9, P=0.01). These data suggest that MRSA BSI is associated with significant mortality among the elderly population. Preventing MRSA acquisition among this patient population is of paramount importance. SN - 0195-6701 UR - https://www.unboundmedicine.com/medline/citation/16978733/Increased_mortality_among_elderly_patients_with_meticillin_resistant_Staphylococcus_aureus_bacteraemia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0195-6701(06)00338-0 DB - PRIME DP - Unbound Medicine ER -