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Comparison of both clinical features and mortality risk associated with bacteremia due to community-acquired methicillin-resistant Staphylococcus aureus and methicillin-susceptible S. aureus.
Clin Infect Dis 2008; 46(6):799-806CI

Abstract

BACKGROUND

The majority of research about community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection has focused on skin and soft-tissue infections. No literature has been published on the clinical features and outcomes of adult patients with CA-MRSA bacteremia in comparison with patients with community-acquired methicillin-susceptible S. aureus (CA-MSSA) bacteremia.

METHODS

From 1 January 2001 through 31 December 2006, the demographic data and outcome of 215 consecutive adult patients admitted to a tertiary care center in Taiwan with S. aureus bacteremia (age, >16 years) who fulfilled the criteria for community-acquired S. aureus bacteremia were collected for analysis.

RESULTS

The mean age (+/-SD) was 56.8+/-20.5 years. There were 30 patients (14%) with CA-MRSA bacteremia and 185 (86%) patients with CA-MSSA bacteremia. Cutaneous abscess (odds ratio, 5.46; 95% confidence interval, 1.66-17.94) and necrotizing pneumonia (odds ratio, 24.81; 95% confidence interval, 2.63-234.03) were the independent predictors of CA-MRSA bacteremia; endovascular infection was the only independent predictor of CA-MSSA bacteremia. After Cox regression analysis, the independent significant risk factors for 30-day mortality included increased age, shock, and thrombocytopenia (<100,000 cells/microL). After adjustment, the day 30 mortality of patients with CA-MRSA bacteremia was not significantly higher than that of patients with CA-MSSA bacteremia (adjusted hazard ratio, 1.01; 95% confidence interval, 0.30-3.39; P = .986). Most (92%) of 25 available CA-MRSA isolates were multilocus sequence typing 59.

CONCLUSIONS

The number of adult patients with CA-MRSA bacteremia increased with time, and the disease was associated with more necrotizing pneumonia and cutaneous abscess but less endovascular infection than was CA-MSSA bacteremia. Patients with CA-MRSA bacteremia did not have higher mortality than did patients with CA-MSSA, even though most of the patients with CA-MRSA bacteremia did not receive empirical glycopeptide therapy.

Authors+Show Affiliations

Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18266610

Citation

Wang, Jiun-Ling, et al. "Comparison of Both Clinical Features and Mortality Risk Associated With Bacteremia Due to Community-acquired Methicillin-resistant Staphylococcus Aureus and Methicillin-susceptible S. Aureus." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 46, no. 6, 2008, pp. 799-806.
Wang JL, Chen SY, Wang JT, et al. Comparison of both clinical features and mortality risk associated with bacteremia due to community-acquired methicillin-resistant Staphylococcus aureus and methicillin-susceptible S. aureus. Clin Infect Dis. 2008;46(6):799-806.
Wang, J. L., Chen, S. Y., Wang, J. T., Wu, G. H., Chiang, W. C., Hsueh, P. R., ... Chang, S. C. (2008). Comparison of both clinical features and mortality risk associated with bacteremia due to community-acquired methicillin-resistant Staphylococcus aureus and methicillin-susceptible S. aureus. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 46(6), pp. 799-806. doi:10.1086/527389.
Wang JL, et al. Comparison of Both Clinical Features and Mortality Risk Associated With Bacteremia Due to Community-acquired Methicillin-resistant Staphylococcus Aureus and Methicillin-susceptible S. Aureus. Clin Infect Dis. 2008 Mar 15;46(6):799-806. PubMed PMID: 18266610.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of both clinical features and mortality risk associated with bacteremia due to community-acquired methicillin-resistant Staphylococcus aureus and methicillin-susceptible S. aureus. AU - Wang,Jiun-Ling, AU - Chen,Shey-Ying, AU - Wang,Jann-Tay, AU - Wu,Grace Hui-Min, AU - Chiang,Wen-Chu, AU - Hsueh,Po-Ren, AU - Chen,Yee-Chun, AU - Chang,Shan-Chwen, PY - 2008/2/13/pubmed PY - 2008/3/19/medline PY - 2008/2/13/entrez SP - 799 EP - 806 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 46 IS - 6 N2 - BACKGROUND: The majority of research about community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection has focused on skin and soft-tissue infections. No literature has been published on the clinical features and outcomes of adult patients with CA-MRSA bacteremia in comparison with patients with community-acquired methicillin-susceptible S. aureus (CA-MSSA) bacteremia. METHODS: From 1 January 2001 through 31 December 2006, the demographic data and outcome of 215 consecutive adult patients admitted to a tertiary care center in Taiwan with S. aureus bacteremia (age, >16 years) who fulfilled the criteria for community-acquired S. aureus bacteremia were collected for analysis. RESULTS: The mean age (+/-SD) was 56.8+/-20.5 years. There were 30 patients (14%) with CA-MRSA bacteremia and 185 (86%) patients with CA-MSSA bacteremia. Cutaneous abscess (odds ratio, 5.46; 95% confidence interval, 1.66-17.94) and necrotizing pneumonia (odds ratio, 24.81; 95% confidence interval, 2.63-234.03) were the independent predictors of CA-MRSA bacteremia; endovascular infection was the only independent predictor of CA-MSSA bacteremia. After Cox regression analysis, the independent significant risk factors for 30-day mortality included increased age, shock, and thrombocytopenia (<100,000 cells/microL). After adjustment, the day 30 mortality of patients with CA-MRSA bacteremia was not significantly higher than that of patients with CA-MSSA bacteremia (adjusted hazard ratio, 1.01; 95% confidence interval, 0.30-3.39; P = .986). Most (92%) of 25 available CA-MRSA isolates were multilocus sequence typing 59. CONCLUSIONS: The number of adult patients with CA-MRSA bacteremia increased with time, and the disease was associated with more necrotizing pneumonia and cutaneous abscess but less endovascular infection than was CA-MSSA bacteremia. Patients with CA-MRSA bacteremia did not have higher mortality than did patients with CA-MSSA, even though most of the patients with CA-MRSA bacteremia did not receive empirical glycopeptide therapy. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/18266610/Comparison_of_both_clinical_features_and_mortality_risk_associated_with_bacteremia_due_to_community_acquired_methicillin_resistant_Staphylococcus_aureus_and_methicillin_susceptible_S__aureus_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/527389 DB - PRIME DP - Unbound Medicine ER -