Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patients

Background The aim of the study was to determine clinical and microbiological differences between patients with methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia (CRB) undergoing or not undergoing haemodialysis, and to compare outcomes. Methods Prospective multicentre s...

Descripción completa

Detalles Bibliográficos
Autores: Cuervo, Guillermo, Camoez, Mariana, Shaw, Evelyn, Domínguez, María Ángeles, Gasch, Oriol, Padilla, Belén, Rodríguez-Baño, Jesús, Lepe Jiménez, José Antonio, Pascual Hernández, Álvaro
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2015
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/172088
Acceso en línea:https://hdl.handle.net/11441/172088
https://doi.org/10.1186/s12879-015-1227-y
Access Level:acceso abierto
Palabra clave:bacteraemia
catheter-related
haemodialysis
MRSA
id ES_366dee99b73323a5e340859b49290d0f
oai_identifier_str oai:idus.us.es:11441/172088
network_acronym_str ES
network_name_str España
repository_id_str
spelling Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patientsCuervo, GuillermoCamoez, MarianaShaw, EvelynDomínguez, María ÁngelesGasch, OriolPadilla, BelénRodríguez-Baño, JesúsLepe Jiménez, José AntonioPascual Hernández, Álvarobacteraemiacatheter-relatedhaemodialysisMRSABackground The aim of the study was to determine clinical and microbiological differences between patients with methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia (CRB) undergoing or not undergoing haemodialysis, and to compare outcomes. Methods Prospective multicentre study conducted at 21 Spanish hospitals of patients with MRSA bacteraemia diagnosed between June 2008 and December 2009. Patients with MRSA-CRB were selected. Data of patients on haemodialysis (HD-CRB) and those not on haemodialysis (non-HD-CRB) were compared. Results Among 579 episodes of MRSA bacteraemia, 218 (37.7 %) were CRB. Thirty-four (15.6 %) were HD-CRB and 184 (84.4 %) non-HD-CRB. All HD-CRB patients acquired the infection at dialysis centres, while in 85.3 % of the non-HD-CRB group the infection was nosocomial (p < .001). There were no differences in age, gender or severity of bacteraemia (Pitt score); comorbidities (Charlson score ≥ 4) were higher in the HD-CRB group than in the non-HD-CRB group (73.5 % vs. 46.2 %, p = .003). Although there were no differences in VAN-MIC ≥1.5 mg/L according to microdilution, using the E-test a higher rate of VAN-MIC ≥1.5 mg/L was observed in HD-CRB than in non-HD-CRB patients (63.3 % vs. 44.1 %, p = .051). Vancomycin was more frequently administered in the HD-CRB group than in the non-HD-CRB group (82.3 % vs. 42.4 %, p = <.001) and therefore the appropriate empirical therapy was significantly higher in HD-CRB group (91.2 % vs. 73.9 %, p = .029). There were no differences with regard to catheter removal (79.4 % vs. 84.2 %, p = .555, respectively). No significant differences in mortality rate were observed between both groups (Overall mortality: 11.8 % vs. 27.2 %, p = .081, respectively), but there was a trend towards a higher recurrence rate in HD-CRB group (8.8 % vs. 2.2 %, p = .076). Conclusions In our multicentre study, ambulatory patients in chronic haemodialysis represented a significant proportion of cases of MRSA catheter-related bacteraemia. Although haemodialysis patients with MRSA catheter-related bacteraemia had significantly more comorbidities and higher proportion of strains with reduced vancomycin susceptibility than non-haemodialysis patients, overall mortality between both groups was similar.BioMed CentralMedicinaMicrobiologíaEuropean Commission (EC). Fondo Europeo de Desarrollo Regional (FEDER)Instituto de Salud Carlos III2015info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/172088https://doi.org/10.1186/s12879-015-1227-yreponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésBMC Infectious Diseases, 15 (1), 484.REIPI RD06/0008FIS 08/0335CM08/228https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-015-1227-yinfo:eu-repo/semantics/openAccessoai:idus.us.es:11441/1720882026-06-17T12:51:07Z
dc.title.none.fl_str_mv Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patients
title Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patients
spellingShingle Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patients
Cuervo, Guillermo
bacteraemia
catheter-related
haemodialysis
MRSA
title_short Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patients
title_full Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patients
title_fullStr Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patients
title_full_unstemmed Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patients
title_sort Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patients
dc.creator.none.fl_str_mv Cuervo, Guillermo
Camoez, Mariana
Shaw, Evelyn
Domínguez, María Ángeles
Gasch, Oriol
Padilla, Belén
Rodríguez-Baño, Jesús
Lepe Jiménez, José Antonio
Pascual Hernández, Álvaro
author Cuervo, Guillermo
author_facet Cuervo, Guillermo
Camoez, Mariana
Shaw, Evelyn
Domínguez, María Ángeles
Gasch, Oriol
Padilla, Belén
Rodríguez-Baño, Jesús
Lepe Jiménez, José Antonio
Pascual Hernández, Álvaro
author_role author
author2 Camoez, Mariana
Shaw, Evelyn
Domínguez, María Ángeles
Gasch, Oriol
Padilla, Belén
Rodríguez-Baño, Jesús
Lepe Jiménez, José Antonio
Pascual Hernández, Álvaro
author2_role author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Medicina
Microbiología
European Commission (EC). Fondo Europeo de Desarrollo Regional (FEDER)
Instituto de Salud Carlos III
dc.subject.none.fl_str_mv bacteraemia
catheter-related
haemodialysis
MRSA
topic bacteraemia
catheter-related
haemodialysis
MRSA
description Background The aim of the study was to determine clinical and microbiological differences between patients with methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia (CRB) undergoing or not undergoing haemodialysis, and to compare outcomes. Methods Prospective multicentre study conducted at 21 Spanish hospitals of patients with MRSA bacteraemia diagnosed between June 2008 and December 2009. Patients with MRSA-CRB were selected. Data of patients on haemodialysis (HD-CRB) and those not on haemodialysis (non-HD-CRB) were compared. Results Among 579 episodes of MRSA bacteraemia, 218 (37.7 %) were CRB. Thirty-four (15.6 %) were HD-CRB and 184 (84.4 %) non-HD-CRB. All HD-CRB patients acquired the infection at dialysis centres, while in 85.3 % of the non-HD-CRB group the infection was nosocomial (p < .001). There were no differences in age, gender or severity of bacteraemia (Pitt score); comorbidities (Charlson score ≥ 4) were higher in the HD-CRB group than in the non-HD-CRB group (73.5 % vs. 46.2 %, p = .003). Although there were no differences in VAN-MIC ≥1.5 mg/L according to microdilution, using the E-test a higher rate of VAN-MIC ≥1.5 mg/L was observed in HD-CRB than in non-HD-CRB patients (63.3 % vs. 44.1 %, p = .051). Vancomycin was more frequently administered in the HD-CRB group than in the non-HD-CRB group (82.3 % vs. 42.4 %, p = <.001) and therefore the appropriate empirical therapy was significantly higher in HD-CRB group (91.2 % vs. 73.9 %, p = .029). There were no differences with regard to catheter removal (79.4 % vs. 84.2 %, p = .555, respectively). No significant differences in mortality rate were observed between both groups (Overall mortality: 11.8 % vs. 27.2 %, p = .081, respectively), but there was a trend towards a higher recurrence rate in HD-CRB group (8.8 % vs. 2.2 %, p = .076). Conclusions In our multicentre study, ambulatory patients in chronic haemodialysis represented a significant proportion of cases of MRSA catheter-related bacteraemia. Although haemodialysis patients with MRSA catheter-related bacteraemia had significantly more comorbidities and higher proportion of strains with reduced vancomycin susceptibility than non-haemodialysis patients, overall mortality between both groups was similar.
publishDate 2015
dc.date.none.fl_str_mv 2015
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/172088
https://doi.org/10.1186/s12879-015-1227-y
url https://hdl.handle.net/11441/172088
https://doi.org/10.1186/s12879-015-1227-y
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv BMC Infectious Diseases, 15 (1), 484.
REIPI RD06/0008
FIS 08/0335
CM08/228
https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-015-1227-y
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869405957568593920
score 15,812429

Similares en LA Referencia