Predictors of methicillin-resistant Staphylococcus aureus colonization at hospital admission

Torres, Katherine Milagros Gómez; Sampathkumar, Priya

doi:10.1016/j.ajic.2013.02.013

Cited by 12 publications

(6 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Diabetes mellitus is associated with an increased likelihood of MRSA colonization upon hospital admission [40] and PVD has been shown to increase risk of developing colonization during a hospitalization [41] or nursing home stay [42]. In addition, PVD is a risk factor for conversion from carrier status to invasive infection during a given hospital admission [43].…”

Section: Methicillin-resistant Staphylococcus Aureus Sstis Epidemiologymentioning

confidence: 99%

Pathophysiology and burden of infection in patients with diabetes mellitus and peripheral vascular disease: focus on skin and soft-tissue infections

Dryden

Baguneid²,

Eckmann

et al. 2015

Clinical Microbiology and Infection

140

110

View full text Add to dashboard Cite

Diabetes mellitus affects 284 million adults worldwide and is increasing in prevalence. Accelerated atherosclerosis in patients with diabetes mellitus contributes an increased risk of developing cardiovascular diseases including peripheral vascular disease (PVD). Immune dysfunction, diabetic neuropathy and poor circulation in patients with diabetes mellitus, especially those with PVD, place these patients at high risk for many types of typical and atypical infections. Complicated skin and soft-tissue infections (cSSTIs) are of particular concern because skin breakdown in patients with advanced diabetes mellitus and PVD provides a portal of entry for bacteria. Patients with diabetes mellitus are more likely to be hospitalized with cSSTIs and to experience related complications than patients without diabetes mellitus. Patients with PVD requiring lower extremity bypass are also at high risk of surgical site and graft infections. Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent causative pathogen in cSSTIs, and may be a significant contributor to surgical site infections, especially in patients who are colonized with MRSA on hospital admission. Patients with cSSTIs and diabetes mellitus or PVD experience lower clinical success rates than patients without these comorbidities, and may also have a longer length of hospital stay and higher risk of adverse drug events. Clinicians should be vigilant in recognizing the potential for infection with multi-drug-resistant organisms, especially MRSA, in these populations and initiating therapy with appropriate antibiotics.

show abstract

Section: Methicillin-resistant Staphylococcus Aureus Sstis Epidemiologymentioning

confidence: 99%

Pathophysiology and burden of infection in patients with diabetes mellitus and peripheral vascular disease: focus on skin and soft-tissue infections

Dryden

Baguneid²,

Eckmann

et al. 2015

Clinical Microbiology and Infection

140

110

View full text Add to dashboard Cite

show abstract

“…Risk factors for MRSA colonization are: former colonization with MRSA, hospitalization in the past, mechanical ventilation, antibiotic therapy, co-morbidity, tracheostomy, renal failure, and chronic skin infections [11-13]. It is evident that neurological early rehabilitation patients carry many of these risk factors, in particular hospitalization including long lasting intensive care therapy, mechanical ventilation, tracheostomy, antibiotic therapy (due to aspiration pneumonia), and co-morbidity [14,15].…”

Section: Introductionmentioning

confidence: 99%

Outcome of MRSA carriers in neurological early rehabilitation

Rollnik

2014

BMC Neurol

View full text Add to dashboard Cite

BackgroundColonization with MRSA is believed to have deteriorating effects on neurological rehabilitation patients because MRSA carriers need to be isolated.MethodsMedical records of neurological early rehabilitation patients (most of them after stroke) admitted to a large rehabilitation facility in Northern Germany in 2010 have been carefully reviewed with respect to MRSA status, outcome variables (functional independence), morbidity, and length of stay (LOS).Results74/569 (13.0%) patients were MRSA positive on admission. MRSA carriers had a significantly longer LOS in early neurological rehabilitation (63.7 (37.1) vs. 25.8 (24.5) days, p < 0.001), worse functional status on admission (Barthel index (BI) 13.6 (9.9) vs. 25.6 (24.1), p < 0.001), worse Glasgow Coma Scale (9.5 (3.2) vs. 12.0 (3.3), p < 0.001), more co-diagnoses (20.5 (5.1) vs. 13.3 (5.5), p < 0.001), and higher Patient Clinical Complexity Levels (PCCL). The outcome was significantly worse among MRSA positive patients (BI 25.5 (21.2) vs. 47.4 (31.0), p < 0.001; Early Rehabilitation Index −47.3 (51.4) vs. -26.0 (35.4), p < 0.001). Isolated patients had slightly less therapy per day (131.6 (16.6) vs. 140.2 (18.7) min/day, p < 0.001), but the overall sum of therapy was significantly larger in the MRSA positive group due to longer LOS.ConclusionsFunctional recovery of MRSA carriers in early neurological rehabilitation is worse than in MRSA negative patients. Poorer outcome is not resulting from isolation (less therapy) but from functional status and higher morbidity on admission.

show abstract

“…Particularly, within the spinal trauma cohort, high rates of MRSA (65% of instrumented trauma patients) were examined, and this cohort accounted for 81.3% of all MRSA cases among the instrumented trauma cases. Risk factors for MRSA infection were previously reported to include long hospitalization, intensive care unit (ICU) hospitalization, and a history of antimicrobial agents’ usage [ 25 , 26 , 27 ]. As most cases of spinal injury involve high-energy trauma, such cases often require extended hospitalization in the ICU, including long preoperative hospitalization and preoperative use of antimicrobial agents.…”

Section: Discussionmentioning

confidence: 99%

Predictive Factors for Successful Treatment of Deep Incisional Surgical Site Infections following Instrumented Spinal Surgeries: Retrospective Review of 1832 Cases

et al. 2022

View full text Add to dashboard Cite

Background: Surgical site infection (SSI) is a major complication in spinal instrumentation that is often difficult to treat. The purpose of this study was to identify and determine prognostic indicators for successful treatment of spine instrumentation SSI. Methods: Retrospectively, spine surgery cases were examined on SSI diagnosis. Post-instrumentation SSI patients were categorized as “Successful” if SSI subsided after single debridement. Patients in whom SSI did not subsided and/or required removal of instrumentation were classified as “Challenging”. We investigated the relation of treatment outcomes to patients and treatment factors. Results: A total of 1832 spinal instrumentation cases were recognized with 44 (2.40%) SSI cases. White blood cell count, C-reactive protein (CRP) levels, causative bacteria (i.e., S. Aureus or MRSA), trauma injury, and early-stage antimicrobial agent sensitivity correlated with treatment prognosis. Multivariate analysis highlighted CRP levels and applying early-stage sensitive antibiotics as potential impactful predictive factors for successful treatment. Conclusions: Our results demonstrated that early selection of sensitive antimicrobial agents is critical and emphasizes the potential for early-stage classification methods such as Gram staining. Additionally, S. Aureus and MRSA SSI formed significantly more challenging infections to treat, thus requiring consideration when deciding on instrumentation retention. These factors offer promising aspects for further large-scale studies.

show abstract

Predictors of methicillin-resistant Staphylococcus aureus colonization at hospital admission

Cited by 12 publications

References 29 publications

Pathophysiology and burden of infection in patients with diabetes mellitus and peripheral vascular disease: focus on skin and soft-tissue infections

Pathophysiology and burden of infection in patients with diabetes mellitus and peripheral vascular disease: focus on skin and soft-tissue infections

Outcome of MRSA carriers in neurological early rehabilitation

Predictive Factors for Successful Treatment of Deep Incisional Surgical Site Infections following Instrumented Spinal Surgeries: Retrospective Review of 1832 Cases

Contact Info

Product

Resources

About