Length of exposure to the hospital environment is more important than antibiotic exposure in healthcare associated infections by methicillin-resistant Staphylococcus aureus: a comparative study
Braz. j. infect. dis
;
15(5): 426-435, Sept.-Oct. 2011. ilus, tab
Artigo
em Inglês
| LILACS
| ID: lil-612700
ABSTRACT
OBJECTIVES:
Both total antimicrobial use and specific antimicrobials have been implicated as risk factors for healthcare-associated methicillin-resistant Staphylococcus aureus (HCA-MRSA) infection. The aims of this study were (I) to explore predictors of a new HCA-MRSA infection in comparison with a new healthcare-associated methicillin-sensitive Staphylococcus aureus (HCA-MSSA); (II) to thoroughly assess the role of recent antibiotic use qualitatively and quantitatively.METHODS:
The time-period for our study was from October 1997 through September 2001. Through applying strict criteria, we identified two groups of inpatients, one with a new HCA-MRSA infection and one with a new HCA-MSSA infection. We recorded demographic, clinical and antibiotic use-related data up to 30 days before the positive culture date.RESULTS:
We identified 127 and 70 patients for each group, respectively. Two logistic regression models were carried out to assess the role of antimicrobial use (qualitatively and quantitatively). In model I, duration of hospital stay, presence of chronic wounds, aminoglycoside and fluoroquinolone use retained statistical significance. In model II, duration of hospital stay and history of intubation during the last month stood out as the only significant predictors of a subsequent HCA-MRSA infection. No significant differences in outcome were noted.CONCLUSIONS:
The length of exposure to the hospital environment may be the best predictor of a new HCA-MRSA infection. Use of aminoglycosides and fluoroquinolones may also stand independently along with presence of chronic ulcers and surgical procedures. No independent association between quantitative antibiotic use and subsequent HCA-MRSA infection was documented.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Infecções Estafilocócicas
/
Infecção Hospitalar
/
Exposição Ambiental
/
Staphylococcus aureus Resistente à Meticilina
/
Antibacterianos
Tipo de estudo:
Estudo de etiologia
/
Estudo observacional
/
Estudo prognóstico
Limite:
Idoso
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Braz. j. infect. dis
Assunto da revista:
Doenças Transmissíveis
Ano de publicação:
2011
Tipo de documento:
Artigo
País de afiliação:
Grécia
/
Estados Unidos
Instituição/País de afiliação:
Alexandra University Hospital/GR
/
Evangelismos General Hospital/GR
/
University Hospital of Patras/GR
Similares
MEDLINE
...
LILACS
LIS