title: Treating Staphylococcus aureus infections in an intensive care unit at a University Hospital in Brazil.
abstract: BACKGROUND
  Optimizing antimicrobial therapy is important for treating patients who are critically ill with Staphylococcus aureus infection, and susceptibility tests are necessary.
  
  
  OBJECTIVE
  The aim of the present study was to evaluate antibacterial therapy after susceptibility testing of S. aureus infections. Setting The setting was an intensive care unit at a University Hospital in Brazil.
  
  
  METHODS
  An observational and retrospective study was conducted over 6 years. The antimicrobials that were used for S. aureus infection treatment were calculated as the defined daily dose per 1000 patient-days (DDD1000). Antimicrobial susceptibility data were obtained by reviewing bacteriological tests. Patient profiles and treatment were determined by analyzing patient charts.
  
  
  RESULTS
  Methicillin-resistant S. aureus (MRSA) was prevalent in this study (76.13 %). Patients who were infected with MRSA had total antimicrobial consumption that was three-times higher (9567.2 DDD1000) than patients who were infected with methicillin-susceptible S. aureus (MSSA; 3101.1 DDD1000). The average length of stay in the intensive care unit was 19 days (interquartile range 17 days) for MSSA and 20 days (interquartile range 20 days) for MRSA. Mortality in patients who were infected with MSSA was higher (52.17 %) than in patients who were infected with MRSA (33.80 %), and de-escalation was not identified in 73.90 % of MSSA patients.
authors.affiliation: University Paranaense, Mascarenhas de Moraes Square, 4282, Umuarama, PR, CEP: 87502-210, Brazil. marinitagimenes@gmail.com.
authors.forename: Marina
authors.initials: M
authors.lastname: Gimenes
authors.affiliation: Faculdade Integrado, Campo Mourão, PR, Brazil.|Post Graduate Program in Biociências e Fisiopatologia, Universidade Estadual de Maringá, Maringá, PR, Brazil.
authors.forename: Tânia Pereira
authors.initials: TP
authors.lastname: Salci
authors.affiliation: Department of Basic Sciences and Health, Universidade Estadual de Maringá, Maringá, PR, Brazil.
authors.forename: Maria Cristina B
authors.initials: MC
authors.lastname: Tognim
authors.affiliation: Departament of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Maringá, PR, Brazil.
authors.forename: Vera Lúcia Dias
authors.initials: VL
authors.lastname: Siqueira
authors.affiliation: Department of Pharmacology and Terapheutics, University of Maringá, Maringá, PR, Brazil.
authors.forename: Silvana Martins
authors.initials: SM
authors.lastname: Caparroz-Assef
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D008875:Middle Aged; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; Brazil; De-escalation; MRSA; MSSA; Staphylococcus aureus