title: Analysis of methicillin resistance among Staphylococcus aureus blood isolates in an emergency department.
abstract: The increasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) has become of great concern in both hospital and community settings. To evaluate the prevalence and risk factors for methicillin resistance among Staphylococcus aureus, blood isolates in our Emergency Department (ED) were collected. All patients with S. aureus bacteremia (SAB) who presented to the ED from January 2000 to August 2005 were included, and a retrospective study was performed. A total of 231 patients with SAB were enrolled (median age, 59 yr; M:F, 125:106). Among these patients, methicillin-resistant strains accounted for 27.3% (63 patients). Catheter-related infection was the most frequent primary site of SAB (39.0%), followed by skin and soft tissue infection (16.5%). In multivariate analysis, recent surgery (OR, 3.41; 95% CI, 1.48-7.85), recent hospitalization (2.17; 1.06-4.62), and older age (> or =61 yr) (2.39; 1.25-4.57) were independently associated with the acquisition of methicillin-resistant strains. When antimicrobial therapy is considered for the treatment of a patient with suspected SAB, clinicians should consider obtaining cultures and modifying empirical therapy to provide MRSA coverage for patients with risk factors: older age, recent hospitalization, and recent surgery.
authors.affiliation: Division of Infectious Diseases, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Korea.
authors.forename: Sang Taek
authors.initials: ST
authors.lastname: Heo
authors.forename: Kyong Ran
authors.initials: KR
authors.lastname: Peck
authors.forename: Seong Yeol
authors.initials: SY
authors.lastname: Ryu
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Kwon
authors.forename: Kwan Soo
authors.initials: KS
authors.lastname: Ko
authors.forename: Won Sup
authors.initials: WS
authors.lastname: Oh
authors.forename: Nam Yong
authors.initials: NY
authors.lastname: Lee
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Song
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D003428:Cross Infection / Q000097:blood / Q000188:drug therapy / Q000382:microbiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008712:Methicillin / Q000494:pharmacology / Q000627:therapeutic use*; D016106:Methicillin Resistance; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000097:blood / Q000188:drug therapy / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D008712:Methicillin