Risk factors for meticillin-resistance among patients with Staphylococcus aureus sepsis
Abstract number: P1071
Lupse M., Flonta M., Almas A., Suciu M., Zanc V.
Community-acquired infections caused by meticillin-resistant Staphylococcus aureus (MRSA) seem to be increasing. Characteristics permitting recognition of patients with such strains would aid infection control efforts and choice of empiric therapy pending culture and susceptibility. The aim of the study was to develop an objective mechanism to estimate the probability of meticillin resistance in a given patient with Staphylococcus aureus sepsis.
Material and Method: Retrospective review of medical records for all adults patients having at admittance in ICU Teaching Hospital of Infectious Diseases (Ian 2006-sept 2007) the diagnosis criteria for sepsis, according to ACCP/SCCM expert panel recommendation, and staphylococcal aetiology. Risk factors for the presence of meticillin resistance in Staphylococcus aureus isolates recovered from patients with staphylococcal sepsis were assessed.
Results: From 285 adult patients non-HIV with sepsis (27% nosocomial sepsis), we selected 50 cases (17.54%) with confirmed Staphylococcus aureus aetiology. Median age was 51.6 years, 26 males (52%). The MRSA rate was 30%. Of 7 characteristics included in the logistic regression (age, hospital onset, number of SIRS criteria, skin ulcers, respiratory involvement, shock, positive blood cultures), the only independent feature for MRSA was hospital onset (p = 0.04)
Conclusions: Through multivariate modeling techniques we confirm that nosocomiality is the most important determinant for MRSA and that patients with MRSA bacteraemia were not significantly older or more severe than those with meticillin-sensitive Staphylococcus aureus bacteraemia.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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