Journal article
Determination of risk factors for recurrent methicillin-resistant Staphylococcus aureus bacteremia in a Veterans Affairs healthcare system population
Infection control and hospital epidemiology, Vol.36(5), pp.543-549
05/2015
DOI: 10.1017/ice.2015.25
PMID: 25682861
Abstract
To identify important risk factors for recurrent methicillin-resistant Staphylococcus aureus (MRSA) to assist clinicians in identifying high-risk patients for continued surveillance and follow-up. In this retrospective cohort study, we examined patients with MRSA bacteremia at 122 Veterans Affairs medical facilities from January 1, 2003, through December 31, 2010. Recurrent MRSA bacteremia was identified by a positive blood culture result from 2 to 180 days after index hospitalization discharge. Subset analyses were performed to evaluate risk factors for early-onset (2-60 days after discharge) and late-onset (61-180 days after discharge) recurrence. Risk factors were evaluated using Cox proportional hazards regression. Of 18,425 patients, 1,159 (6.3%) had recurrent MRSA bacteremia. The median time to recurrence was 63 days. Longer duration of index bacteremia, increased severity of illness, receipt of only vancomycin, community-acquired infection, and several comorbidities were risk factors for recurrence. Congestive heart failure, hypertension, and rheumatoid arthritis/collagen disease were risk factors for early-onset but not late-onset recurrence. Geographic region and cardiac arrhythmias were risk factors for late-onset but not early-onset recurrence. Risk factors for recurrent MRSA bacteremia included comorbidities, severity of illness, duration of bacteremia, and receipt of only vancomycin. Awareness of risk factors may be important at patient discharge for implementation of quality improvement initiatives including surveillance, follow-up, and education for high-risk patients.
Details
- Title: Subtitle
- Determination of risk factors for recurrent methicillin-resistant Staphylococcus aureus bacteremia in a Veterans Affairs healthcare system population
- Creators
- Justin Albertson - University of IowaJennifer S McDanel - University of Iowa, Internal MedicineRyan Carnahan - University of Iowa, EpidemiologyElizabeth Chrischilles - University of Iowa, EpidemiologyEli N Perencevich - University of Iowa, Internal MedicineMichihiko Goto - University of Iowa, Internal MedicineLan Jiang - Iowa City VA Medical CenterBruce Alexander - Iowa City VA Medical CenterMarin L Schweizer - University of Iowa, Epidemiology
- Resource Type
- Journal article
- Publication Details
- Infection control and hospital epidemiology, Vol.36(5), pp.543-549
- DOI
- 10.1017/ice.2015.25
- PMID
- 25682861
- NLM abbreviation
- Infect Control Hosp Epidemiol
- ISSN
- 0899-823X
- eISSN
- 1559-6834
- Publisher
- United States
- Language
- English
- Date published
- 05/2015
- Academic Unit
- Pharmacy; Psychiatry; Infectious Diseases; Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9983779498702771
Metrics
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