Active surveillance to determine the impact of methicillin resistance on mortality in patients with bacteremia and influences of the use of antibiotics on the development of MRSA infection

AUTOR(ES)

Porto, Juliana Pena, Santos, Rosana Oliveira, Gontijo Filho, Paulo Pinto, Ribas, Rosineide Marques

FONTE

Rev. Soc. Bras. Med. Trop.

DATA DE PUBLICAÇÃO

2013-12

RESUMO

Introduction Methicillin-resistant Staphylococcus aureus (MRSA) is among the most important pathogens of nosocomial infections, mainly in intensive care units (ICUs), and accounts for 40-60% of all healthcare-associated S. aureus infections. We evaluated the incidence of nosocomial infection by S. aureus, identified the risk factors for MRSA infection, and evaluated the effect of resistance to methicillin on mortality in patients. Methods We conducted MRSA surveillance at a university hospital in Brazil from January 1, 2010, to December 31, 2010, and performed a retrospective case-control matched study to evaluate the frequency of subsequent MRSA bacteremia and death among patients. We evaluated and compared the risk factors between patients with MRSA and methicillin-sensitive Staphylococcus aureus (MSSA) infection. Results Sepsis was the most common cause of infection (17.7/1,000 patient-days), followed by surgical site (11.4/1,000 patient-days), pneumonia (4.1/1,000 patient-days), and urinary tract infection (2.4/1,000 patient-days). The significant risk factors were time of hospitalization, use of central vascular catheter (CVC), urinary catheter, nasogastric tube, parenteral nutrition, tracheostomy, mechanical ventilation, and previous antibiotic administration, the latter of which was the only independent risk factor for MRSA infection. Mortality was significantly higher in patients with MRSA. The number of antibiotics tested was not related to increases in the frequency of MRSA/1,000 patient-days. The incidence of mortality attributable to MRSA (bloodstream infection) BSI was 50%. Conclusions Surveillance results showed that the use of high levels of antibiotics was directly related to the development of MRSA infection, and the mortality attributable to MRSA in patients with bacteremia was significant.

Documentos Relacionados

• Staphylococcus aureus bacteremia: what is the impact of oxacillin resistance on mortality?
• Infection rate and use of antibiotics in patients with rheumatoid arthritis treated with methotrexate.
• Detection of Methicillin-Resistant Staphylococcus aureus (MRSA) in Blood with the EVIGENE MRSA Detection Kit
• Further Evaluation of the MRSA-Screen Kit for Rapid Detection of Methicillin Resistance
• THE EFFECT OF ULTRAVIOLET IRRADIATION ON THE DEVELOPMENT OF RESISTANCE OF BACTERIA TO ANTIBIOTICS1