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PLoS One. 2014;9(12):e114127.

Clinical and epidemiological factors associated with methicillin resistance in community-onset invasive Staphylococcus aureus infections: prospective multicenter cross-sectional study in Korea.

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제1저자 김홍빈 · 교신저자 오명돈

소속 (8)
  1. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
  2. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
  3. Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea.
  4. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
  5. Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea.
  6. Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Republic of Korea.
  7. Department of Laboratory Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea.
  8. Center for Infectious Diseases, Korea National Institute of Health, Osong, Republic of Korea.

Abstract

Successful empirical therapy of Staphylococcus aureus infections requires the ability to predict methicillin resistance. Our aim was to identify predictors of methicillin resistance in community-onset (CO) invasive S. aureus infections. Sixteen hospitals across Korea participated in this study from May to December 2012. We prospectively included cases of S. aureus infection in which S. aureus was isolated from sterile clinical specimens ≤ 72 hours after hospitalization. Clinical and epidemiological data were gathered and compared in methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) cases. Community-associated (CA) infections were defined as in previous studies. In total, there were 786 cases of community-onset S. aureus infection, 102 (13.0%) of which were CA-MRSA. In addition to known risk factors, exposure to 3rd generation cephalosporins in the past 6 months [odds ratio (OR), 1.922; 95% confidence interval (CI), 1.176-3.142] and close contact with chronically ill patients in the past month (OR, 2.647; 95% CI, 1.189-5.891) were independent risk factors for MRSA infection. However, no clinical predictors of CA-MRSA were identified. Methicillin resistance, CO infection, and appropriateness of empirical antibiotics were not significantly related to 30-day mortality. MRSA infection should be suspected in patients recently exposed to 3rd generation cephalosporins or chronically-ill patients. There were no reliable predictors of CA-MRSA infection, and mortality was not affected by methicillin resistance.

Figures

Figure 1
Figure 1 Schematic diagram describing the classification of Staphylococcus aureus infections as community-associated (CA) or healthcare-associated (HA) according to methicillin-resistance (MRSA) or methicillin susceptibility (MSSA).
Figure 2
Figure 2 Antibiotic susceptibility profiles of the community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) isolates and the healthcare-associated MRSA (HA-MRSA) isolates. ERY, CLI, CIP, RIF, SUL, GEN, TET, VAN, and TEI denote erythromycin, clindamycin, ciprofloxacin, rifampin, sulfamethoxazole-trimethoprim, gentamicin, tetracycline, vancomycin, and teicoplanin, respectively. Data for CIP, RIF, SUL, GEN, TET, and TEI were missing for 2, 1, 34, 4, 2, and 1 patient(s), respectively. * and ** indicate statistical significance at P<0.05 and 0.01, respectively (χ2 test).

그림 출처: PubMed Central 공개 논문 (PMC4259386)

Conflict of interest statement

Competing Interests:The authors have declared that no competing interests exist.

그 밖의 정보
출판 형태
Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't
저널
PloS one · eISSN 1932-6203
전자 출판
2014-12-08
MeSH
Adolescent · Adult · Aged · Aged, 80 and over · Anti-Bacterial Agents / pharmacology · Child · Child, Preschool · Community-Acquired Infections* · Comorbidity · Cross-Sectional Studies · Female · Humans · Infant · Infant, Newborn · Male · Methicillin-Resistant Staphylococcus aureus* / drug effects / isolation & purification · Microbial Sensitivity Tests · Middle Aged · Patient Outcome Assessment · Prospective Studies · Public Health Surveillance · Republic of Korea / epidemiology · Risk Factors · Staphylococcal Infections / drug therapy / epidemiology / microbiology · Young Adult
Substances
Anti-Bacterial Agents
참고문헌
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