Analysis of methicillin resistance among Staphylococcus aureus blood isolates in an emergency department.
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.
Heo
Sang Taek
ST
Division of Infectious Diseases, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Korea.
Peck
Kyong Ran
KR
Ryu
Seong Yeol
SY
Kwon
Ki Tae
KT
Ko
Kwan Soo
KS
Oh
Won Sup
WS
Lee
Nam Yong
NY
Song
Jae Hoon
JH
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
D000900:Anti-Bacterial Agents; D008712:Methicillin