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
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...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2011-09-01
|
| Series: | Brazilian Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1413867011702239 |
| _version_ | 1818941836752846848 |
|---|---|
| author | Ioannis G. Baraboutis, MD Eleftheria P. Tsagalou Ilias Papakonstantinou Markos N. Marangos Charalambos Gogos Athanasios T. Skoutelis Haralambos (Harry) Bassaris Stuart Johnson |
| author_facet | Ioannis G. Baraboutis, MD Eleftheria P. Tsagalou Ilias Papakonstantinou Markos N. Marangos Charalambos Gogos Athanasios T. Skoutelis Haralambos (Harry) Bassaris Stuart Johnson |
| author_sort | Ioannis G. Baraboutis, MD |
| collection | DOAJ |
| description | 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. Keywords: methicillin-resistant Staphylococcus aureus, Staphylococcus aureus, antibacterial agents, fluoroquinolones |
| first_indexed | 2024-12-20T07:01:52Z |
| format | Article |
| id | doaj.art-8f524fb9a00940a2bdc2abfb2738425d |
| institution | Directory Open Access Journal |
| issn | 1413-8670 |
| language | English |
| last_indexed | 2024-12-20T07:01:52Z |
| publishDate | 2011-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-8f524fb9a00940a2bdc2abfb2738425d2022-12-21T19:49:11ZengElsevierBrazilian Journal of Infectious Diseases1413-86702011-09-01155426435Length of exposure to the hospital environment is more important than antibiotic exposure in healthcare associated infections by methicillin-resistant Staphylococcus aureus: a comparative studyIoannis G. Baraboutis, MD0Eleftheria P. Tsagalou1Ilias Papakonstantinou2Markos N. Marangos3Charalambos Gogos4Athanasios T. Skoutelis5Haralambos (Harry) Bassaris6Stuart Johnson7Consultant, Infectious Diseases and HIV Division, Evangelismos General Hospital, Athens, Greece; Correspondence to: Evangelismos General Hospital 45-47 Ipsilantou Street 10676, Athens, Greece Phone: +30 210 7201242 Fax: +30 210 7201320.Consultant, Department of Clinical Therapeutics, Alexandra University Hospital, Athens, GreeceConsultant, Internal Medicine, Evangelismos General Hospital, Athens, GreeceAssociate Professor of Infectious Diseases; Consultant, Infectious Diseases, University Hospital of Patras, GreeceProfessor of Internal Medicine, University Hospital of Patras, GreeceProfessor of Internal Medicine and Infectious Diseases; Director, Infectious Diseases Division, Evangelismos General Hospital, Athens, GreeceProfessor of Internal Medicine and Infectious Diseases, University Hospital of Patras, GreeceAssociate Professor of Infectious Diseases; Loyola University Medical Center & Hines VA Hospital, USAObjectives: 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. Keywords: methicillin-resistant Staphylococcus aureus, Staphylococcus aureus, antibacterial agents, fluoroquinoloneshttp://www.sciencedirect.com/science/article/pii/S1413867011702239 |
| spellingShingle | Ioannis G. Baraboutis, MD Eleftheria P. Tsagalou Ilias Papakonstantinou Markos N. Marangos Charalambos Gogos Athanasios T. Skoutelis Haralambos (Harry) Bassaris Stuart Johnson 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 Brazilian Journal of Infectious Diseases |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| url | http://www.sciencedirect.com/science/article/pii/S1413867011702239 |
| work_keys_str_mv | AT ioannisgbaraboutismd lengthofexposuretothehospitalenvironmentismoreimportantthanantibioticexposureinhealthcareassociatedinfectionsbymethicillinresistantstaphylococcusaureusacomparativestudy AT eleftheriaptsagalou lengthofexposuretothehospitalenvironmentismoreimportantthanantibioticexposureinhealthcareassociatedinfectionsbymethicillinresistantstaphylococcusaureusacomparativestudy AT iliaspapakonstantinou lengthofexposuretothehospitalenvironmentismoreimportantthanantibioticexposureinhealthcareassociatedinfectionsbymethicillinresistantstaphylococcusaureusacomparativestudy AT markosnmarangos lengthofexposuretothehospitalenvironmentismoreimportantthanantibioticexposureinhealthcareassociatedinfectionsbymethicillinresistantstaphylococcusaureusacomparativestudy AT charalambosgogos lengthofexposuretothehospitalenvironmentismoreimportantthanantibioticexposureinhealthcareassociatedinfectionsbymethicillinresistantstaphylococcusaureusacomparativestudy AT athanasiostskoutelis lengthofexposuretothehospitalenvironmentismoreimportantthanantibioticexposureinhealthcareassociatedinfectionsbymethicillinresistantstaphylococcusaureusacomparativestudy AT haralambosharrybassaris lengthofexposuretothehospitalenvironmentismoreimportantthanantibioticexposureinhealthcareassociatedinfectionsbymethicillinresistantstaphylococcusaureusacomparativestudy AT stuartjohnson lengthofexposuretothehospitalenvironmentismoreimportantthanantibioticexposureinhealthcareassociatedinfectionsbymethicillinresistantstaphylococcusaureusacomparativestudy |