Limits...
Predicting risk for death from MRSA bacteremia.

Pastagia M, Kleinman LC, Lacerda de la Cruz EG, Jenkins SG - Emerging Infect. Dis. (2012)

Bottom Line: Among the 699 episodes, 55 were caused by vancomycin-intermediate resistant S. aureus strains, 55 by heteroresistant vancomycin-intermediate S. aureus strains, and 589 by non-vancomycin-resistant strains; 190 (31.5%) patients died.We used regression risk analysis to quantify the association between clinical correlates and death.We found that older age, residence in a nursing home, severe bacteremia, and organ impairment were independently associated with increased risk for death; consultation with an infectious disease specialist was associated with lower risk for death; and MRSA strain types were not associated with risk for death.

View Article: PubMed Central - PubMed

Affiliation: The Rockefeller University, New York, New York 10065, USA. minapastagia@yahoo.com

ABSTRACT
Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is often fatal. To determine predictors of risk for death, we conducted a retrospective cohort study. We examined 699 episodes of MRSA bacteremia involving 603 patients admitted to an academic medical center in New York City during 2002-2007. Data came from chart reviews, hospital databases, and recultured frozen MRSA specimens. Among the 699 episodes, 55 were caused by vancomycin-intermediate resistant S. aureus strains, 55 by heteroresistant vancomycin-intermediate S. aureus strains, and 589 by non-vancomycin-resistant strains; 190 (31.5%) patients died. We used regression risk analysis to quantify the association between clinical correlates and death. We found that older age, residence in a nursing home, severe bacteremia, and organ impairment were independently associated with increased risk for death; consultation with an infectious disease specialist was associated with lower risk for death; and MRSA strain types were not associated with risk for death.

Show MeSH

Related in: MedlinePlus

Trend of methicillin-resistant Staphylococcus aureus (MRSA) infection strain types, New York, New York, USA, 2002–2007. VISA, vancomycin-intermediate S. aureus strains, hVISA, heteroresistant vancomycin-intermediate S. aureus strains.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3376787&req=5

Figure 1: Trend of methicillin-resistant Staphylococcus aureus (MRSA) infection strain types, New York, New York, USA, 2002–2007. VISA, vancomycin-intermediate S. aureus strains, hVISA, heteroresistant vancomycin-intermediate S. aureus strains.

Mentions: Each year during 2002–2006, the annual number of hospital admissions in this study were 117, 77, 147, 121, and 161, respectively; through May 31, 2007, another 76 patients were hospitalized (equivalent to 184 annual hospitalizations). The original testing of strains by Microscan did not detect VISA; repeat testing using the Vitek 2 detected 2 (25%) of 8 study strains and 2 (20%) of 10 control strains. The rate at which polymicrobial bacteremia met inclusion criteria was 3% (20 episodes). The Figure demonstrates the proportion of VISA, hVISA, and non–VISA/hVISA MRSA by year and the increase in mean vancomycin MICs during the study period. The vancomycin MICs for most (87%) isolates were 1–2 µg/mL. For VISA, MICs were as high as 12 µg/mL, although for 60%, MICs were 4 µg/mL. For 94% of hVISA strains, vancomycin MICs were 1.5–2.0 µg/mL.


Predicting risk for death from MRSA bacteremia.

Pastagia M, Kleinman LC, Lacerda de la Cruz EG, Jenkins SG - Emerging Infect. Dis. (2012)

Trend of methicillin-resistant Staphylococcus aureus (MRSA) infection strain types, New York, New York, USA, 2002–2007. VISA, vancomycin-intermediate S. aureus strains, hVISA, heteroresistant vancomycin-intermediate S. aureus strains.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3376787&req=5

Figure 1: Trend of methicillin-resistant Staphylococcus aureus (MRSA) infection strain types, New York, New York, USA, 2002–2007. VISA, vancomycin-intermediate S. aureus strains, hVISA, heteroresistant vancomycin-intermediate S. aureus strains.
Mentions: Each year during 2002–2006, the annual number of hospital admissions in this study were 117, 77, 147, 121, and 161, respectively; through May 31, 2007, another 76 patients were hospitalized (equivalent to 184 annual hospitalizations). The original testing of strains by Microscan did not detect VISA; repeat testing using the Vitek 2 detected 2 (25%) of 8 study strains and 2 (20%) of 10 control strains. The rate at which polymicrobial bacteremia met inclusion criteria was 3% (20 episodes). The Figure demonstrates the proportion of VISA, hVISA, and non–VISA/hVISA MRSA by year and the increase in mean vancomycin MICs during the study period. The vancomycin MICs for most (87%) isolates were 1–2 µg/mL. For VISA, MICs were as high as 12 µg/mL, although for 60%, MICs were 4 µg/mL. For 94% of hVISA strains, vancomycin MICs were 1.5–2.0 µg/mL.

Bottom Line: Among the 699 episodes, 55 were caused by vancomycin-intermediate resistant S. aureus strains, 55 by heteroresistant vancomycin-intermediate S. aureus strains, and 589 by non-vancomycin-resistant strains; 190 (31.5%) patients died.We used regression risk analysis to quantify the association between clinical correlates and death.We found that older age, residence in a nursing home, severe bacteremia, and organ impairment were independently associated with increased risk for death; consultation with an infectious disease specialist was associated with lower risk for death; and MRSA strain types were not associated with risk for death.

View Article: PubMed Central - PubMed

Affiliation: The Rockefeller University, New York, New York 10065, USA. minapastagia@yahoo.com

ABSTRACT
Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is often fatal. To determine predictors of risk for death, we conducted a retrospective cohort study. We examined 699 episodes of MRSA bacteremia involving 603 patients admitted to an academic medical center in New York City during 2002-2007. Data came from chart reviews, hospital databases, and recultured frozen MRSA specimens. Among the 699 episodes, 55 were caused by vancomycin-intermediate resistant S. aureus strains, 55 by heteroresistant vancomycin-intermediate S. aureus strains, and 589 by non-vancomycin-resistant strains; 190 (31.5%) patients died. We used regression risk analysis to quantify the association between clinical correlates and death. We found that older age, residence in a nursing home, severe bacteremia, and organ impairment were independently associated with increased risk for death; consultation with an infectious disease specialist was associated with lower risk for death; and MRSA strain types were not associated with risk for death.

Show MeSH
Related in: MedlinePlus