Healthcare-associated vs. hospital-acquired Staphylococcus aureus bacteremia
Summary Objective To analyze clinical features and outcomes of patients with hospital-acquired (HA) and healthcare-associated (HCA) Staphylococcus aureus bacteremia. Methods A retrospective cohort study was conducted from 1988 to 2007. We compared patients with clinically significant HA with those w...
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| Veröffentlicht in: | International journal of infectious diseases 2012-06, Vol.16 (6), p.e457-e463 |
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| creator | Bishara, Jihad Goldberg, Elad Leibovici, Leonard Samra, Zmira Shaked, Hila Mansur, Nariman Paul, Mical |
| description | Summary Objective To analyze clinical features and outcomes of patients with hospital-acquired (HA) and healthcare-associated (HCA) Staphylococcus aureus bacteremia. Methods A retrospective cohort study was conducted from 1988 to 2007. We compared patients with clinically significant HA with those with HCA S. aureus bacteremia. Risk factors for 30-day all-cause mortality were assessed using multivariable logistic regression analysis. Cox regression analysis was used to estimate the hazard ratio (HR) for 5-year mortality with 95% confidence intervals (CI). Results Of 1261 episodes, 735 (58.3%) were HA and 526 (41.7%) were HCA. The percentage of MRSA was 48.2% (354/735) in HA vs. 42.2% (222/526) in HCA bacteremia; p = 0.04. The percentages of HCA S. aureus bacteremia and MRSA bacteremia did not vary throughout the study period. Mortality at 30 days was 40.2% (507/1261) and at 1 year was 63.4% (800/1261); this was comparable for HA and HCA bacteremia. Five-year survival curves in both settings followed very similar patterns (HR 1.01, 95% CI 0.89–1.15). Risk factors for 30-day mortality were similar, except for primary bacteremia and pre-existing heart valve disease in the HA group. Conclusions HCA S. aureus bacteremia shares many similarities with HA bacteremia with respect to the prevalence of MRSA strains, mortality rates, and risk factors for death, and should be managed similarly. |
| doi_str_mv | 10.1016/j.ijid.2012.02.009 |
| format | Article |
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Methods A retrospective cohort study was conducted from 1988 to 2007. We compared patients with clinically significant HA with those with HCA S. aureus bacteremia. Risk factors for 30-day all-cause mortality were assessed using multivariable logistic regression analysis. Cox regression analysis was used to estimate the hazard ratio (HR) for 5-year mortality with 95% confidence intervals (CI). Results Of 1261 episodes, 735 (58.3%) were HA and 526 (41.7%) were HCA. The percentage of MRSA was 48.2% (354/735) in HA vs. 42.2% (222/526) in HCA bacteremia; p = 0.04. The percentages of HCA S. aureus bacteremia and MRSA bacteremia did not vary throughout the study period. Mortality at 30 days was 40.2% (507/1261) and at 1 year was 63.4% (800/1261); this was comparable for HA and HCA bacteremia. Five-year survival curves in both settings followed very similar patterns (HR 1.01, 95% CI 0.89–1.15). Risk factors for 30-day mortality were similar, except for primary bacteremia and pre-existing heart valve disease in the HA group. Conclusions HCA S. aureus bacteremia shares many similarities with HA bacteremia with respect to the prevalence of MRSA strains, mortality rates, and risk factors for death, and should be managed similarly.</description><identifier>ISSN: 1201-9712</identifier><identifier>EISSN: 1878-3511</identifier><identifier>DOI: 10.1016/j.ijid.2012.02.009</identifier><identifier>PMID: 22497966</identifier><language>eng</language><publisher>Canada: Elsevier Ltd</publisher><subject>Bacteremia - microbiology ; Bacteremia - mortality ; Cohort Studies ; Community-Acquired Infections - microbiology ; Community-Acquired Infections - mortality ; Cross Infection - microbiology ; Cross Infection - mortality ; Healthcare ; Hospitalization ; Humans ; Infectious Disease ; Israel ; Mortality ; MRSA ; Nosocomial ; Prevalence ; Pulmonary/Respiratory ; Regression Analysis ; Retrospective Studies ; Risk Factors ; Staphylococcal Infections - microbiology ; Staphylococcal Infections - mortality ; Staphylococcus aureus ; Staphylococcus aureus - isolation & purification ; Survival Rate</subject><ispartof>International journal of infectious diseases, 2012-06, Vol.16 (6), p.e457-e463</ispartof><rights>International Society for Infectious Diseases</rights><rights>2012 International Society for Infectious Diseases</rights><rights>Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-3d628d4047973c0e83a175032a7ddc79b35495013edf6308895145afd5daa4d83</citedby><cites>FETCH-LOGICAL-c455t-3d628d4047973c0e83a175032a7ddc79b35495013edf6308895145afd5daa4d83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijid.2012.02.009$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,777,781,861,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22497966$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bishara, Jihad</creatorcontrib><creatorcontrib>Goldberg, Elad</creatorcontrib><creatorcontrib>Leibovici, Leonard</creatorcontrib><creatorcontrib>Samra, Zmira</creatorcontrib><creatorcontrib>Shaked, Hila</creatorcontrib><creatorcontrib>Mansur, Nariman</creatorcontrib><creatorcontrib>Paul, Mical</creatorcontrib><title>Healthcare-associated vs. hospital-acquired Staphylococcus aureus bacteremia</title><title>International journal of infectious diseases</title><addtitle>Int J Infect Dis</addtitle><description>Summary Objective To analyze clinical features and outcomes of patients with hospital-acquired (HA) and healthcare-associated (HCA) Staphylococcus aureus bacteremia. Methods A retrospective cohort study was conducted from 1988 to 2007. We compared patients with clinically significant HA with those with HCA S. aureus bacteremia. Risk factors for 30-day all-cause mortality were assessed using multivariable logistic regression analysis. Cox regression analysis was used to estimate the hazard ratio (HR) for 5-year mortality with 95% confidence intervals (CI). Results Of 1261 episodes, 735 (58.3%) were HA and 526 (41.7%) were HCA. The percentage of MRSA was 48.2% (354/735) in HA vs. 42.2% (222/526) in HCA bacteremia; p = 0.04. The percentages of HCA S. aureus bacteremia and MRSA bacteremia did not vary throughout the study period. Mortality at 30 days was 40.2% (507/1261) and at 1 year was 63.4% (800/1261); this was comparable for HA and HCA bacteremia. Five-year survival curves in both settings followed very similar patterns (HR 1.01, 95% CI 0.89–1.15). Risk factors for 30-day mortality were similar, except for primary bacteremia and pre-existing heart valve disease in the HA group. Conclusions HCA S. aureus bacteremia shares many similarities with HA bacteremia with respect to the prevalence of MRSA strains, mortality rates, and risk factors for death, and should be managed similarly.</description><subject>Bacteremia - microbiology</subject><subject>Bacteremia - mortality</subject><subject>Cohort Studies</subject><subject>Community-Acquired Infections - microbiology</subject><subject>Community-Acquired Infections - mortality</subject><subject>Cross Infection - microbiology</subject><subject>Cross Infection - mortality</subject><subject>Healthcare</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Infectious Disease</subject><subject>Israel</subject><subject>Mortality</subject><subject>MRSA</subject><subject>Nosocomial</subject><subject>Prevalence</subject><subject>Pulmonary/Respiratory</subject><subject>Regression Analysis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Staphylococcal Infections - microbiology</subject><subject>Staphylococcal Infections - mortality</subject><subject>Staphylococcus aureus</subject><subject>Staphylococcus aureus - isolation & purification</subject><subject>Survival Rate</subject><issn>1201-9712</issn><issn>1878-3511</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUuLFDEUhYMozkP_gAvppZsqbyqVF4gggzpCg4vRdbid3KZTVnd6kqqB_veTokcXsxAunJCccyDfZewdh5YDVx-HNg4xtB3wroU6YF-wS260aYTk_GU916fGat5dsKtSBgDolTKv2UXX9VZbpS7Z-pZwnHYeMzVYSvIRJwqrh9Kudqkc44Rjg_5-jrne3k143J3G5JP3c1nhnKnKBv1EmfYR37BXWxwLvX3Sa_b729dfN7fN-uf3Hzdf1o3vpZwaEVRnQg-9tlp4ICOQawmiQx2C13YjZG8lcEFhqwQYYyXvJW6DDIh9MOKafTj3HnO6n6lMbh-Lp3HEA6W5uEoHlDBK2GrtzlafUymZtu6Y4x7zqZoWn3KDWyi6haKDOrCE3j_1z5s9hX-Rv9iq4dPZQPWXD5GyKz7SwVOonPzkQor_7__8LO7HeIgexz90ojKkOR8qP8ddqQF3t-xxWWNVAKW1eAR-uZfM</recordid><startdate>20120601</startdate><enddate>20120601</enddate><creator>Bishara, Jihad</creator><creator>Goldberg, Elad</creator><creator>Leibovici, Leonard</creator><creator>Samra, Zmira</creator><creator>Shaked, Hila</creator><creator>Mansur, Nariman</creator><creator>Paul, Mical</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120601</creationdate><title>Healthcare-associated vs. hospital-acquired Staphylococcus aureus bacteremia</title><author>Bishara, Jihad ; Goldberg, Elad ; Leibovici, Leonard ; Samra, Zmira ; Shaked, Hila ; Mansur, Nariman ; Paul, Mical</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-3d628d4047973c0e83a175032a7ddc79b35495013edf6308895145afd5daa4d83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Bacteremia - microbiology</topic><topic>Bacteremia - mortality</topic><topic>Cohort Studies</topic><topic>Community-Acquired Infections - microbiology</topic><topic>Community-Acquired Infections - mortality</topic><topic>Cross Infection - microbiology</topic><topic>Cross Infection - mortality</topic><topic>Healthcare</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Infectious Disease</topic><topic>Israel</topic><topic>Mortality</topic><topic>MRSA</topic><topic>Nosocomial</topic><topic>Prevalence</topic><topic>Pulmonary/Respiratory</topic><topic>Regression Analysis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Staphylococcal Infections - microbiology</topic><topic>Staphylococcal Infections - mortality</topic><topic>Staphylococcus aureus</topic><topic>Staphylococcus aureus - isolation & purification</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bishara, Jihad</creatorcontrib><creatorcontrib>Goldberg, Elad</creatorcontrib><creatorcontrib>Leibovici, Leonard</creatorcontrib><creatorcontrib>Samra, Zmira</creatorcontrib><creatorcontrib>Shaked, Hila</creatorcontrib><creatorcontrib>Mansur, Nariman</creatorcontrib><creatorcontrib>Paul, Mical</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bishara, Jihad</au><au>Goldberg, Elad</au><au>Leibovici, Leonard</au><au>Samra, Zmira</au><au>Shaked, Hila</au><au>Mansur, Nariman</au><au>Paul, Mical</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Healthcare-associated vs. hospital-acquired Staphylococcus aureus bacteremia</atitle><jtitle>International journal of infectious diseases</jtitle><addtitle>Int J Infect Dis</addtitle><date>2012-06-01</date><risdate>2012</risdate><volume>16</volume><issue>6</issue><spage>e457</spage><epage>e463</epage><pages>e457-e463</pages><issn>1201-9712</issn><eissn>1878-3511</eissn><abstract>Summary Objective To analyze clinical features and outcomes of patients with hospital-acquired (HA) and healthcare-associated (HCA) Staphylococcus aureus bacteremia. Methods A retrospective cohort study was conducted from 1988 to 2007. We compared patients with clinically significant HA with those with HCA S. aureus bacteremia. Risk factors for 30-day all-cause mortality were assessed using multivariable logistic regression analysis. Cox regression analysis was used to estimate the hazard ratio (HR) for 5-year mortality with 95% confidence intervals (CI). Results Of 1261 episodes, 735 (58.3%) were HA and 526 (41.7%) were HCA. The percentage of MRSA was 48.2% (354/735) in HA vs. 42.2% (222/526) in HCA bacteremia; p = 0.04. The percentages of HCA S. aureus bacteremia and MRSA bacteremia did not vary throughout the study period. Mortality at 30 days was 40.2% (507/1261) and at 1 year was 63.4% (800/1261); this was comparable for HA and HCA bacteremia. Five-year survival curves in both settings followed very similar patterns (HR 1.01, 95% CI 0.89–1.15). Risk factors for 30-day mortality were similar, except for primary bacteremia and pre-existing heart valve disease in the HA group. Conclusions HCA S. aureus bacteremia shares many similarities with HA bacteremia with respect to the prevalence of MRSA strains, mortality rates, and risk factors for death, and should be managed similarly.</abstract><cop>Canada</cop><pub>Elsevier Ltd</pub><pmid>22497966</pmid><doi>10.1016/j.ijid.2012.02.009</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Bacteremia - microbiology Bacteremia - mortality Cohort Studies Community-Acquired Infections - microbiology Community-Acquired Infections - mortality Cross Infection - microbiology Cross Infection - mortality Healthcare Hospitalization Humans Infectious Disease Israel Mortality MRSA Nosocomial Prevalence Pulmonary/Respiratory Regression Analysis Retrospective Studies Risk Factors Staphylococcal Infections - microbiology Staphylococcal Infections - mortality Staphylococcus aureus Staphylococcus aureus - isolation & purification Survival Rate |
| title | Healthcare-associated vs. hospital-acquired Staphylococcus aureus bacteremia |
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