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Title: | Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patients |
Author: | Cuervo Requena, Guillermo Camoez, Mariana Shaw Perujo, Evelyn Domínguez Luzón, Ma. Ángeles (María Ángeles) Gasch, Oriol Padilla, Belén Pintado, Vicente Almirante, Benito Molina, José López Medrano, Francisco Ruiz de Gopegui, Enrique Martínez Martínez, José Antonio Bereciartua, Elena Rodriguez-Lopez, Fernando Fernandez-Mazarrasa, Carlos Goenaga Sánchez, Miguel Ángel Benito Hernández, M. Natividad de Rodríguez Baño, Jesús Espejo, Elena Pujol Rojo, Miquel Spanish Network for Research in Infectious Diseases (REIPI) GEIH (Hospital Infection Study Group) |
Keywords: | Staphylococcus aureus Estafilococs Bacteris Cateterisme Hemodiàlisi Staphylococcus aureus Staphylococcus Bacteria Catheterization Hemodialysis |
Issue Date: | 30-Oct-2015 |
Publisher: | BioMed Central |
Abstract: | 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. |
Note: | Reproducció del document publicat a: https://doi.org/10.1186/s12879-015-1227-y |
It is part of: | Bmc Infectious Diseases, 2015, vol. 15, p. 484 |
URI: | http://hdl.handle.net/2445/108323 |
Related resource: | https://doi.org/10.1186/s12879-015-1227-y |
ISSN: | 1471-2334 |
Appears in Collections: | Articles publicats en revistes (Medicina) Articles publicats en revistes (Patologia i Terapèutica Experimental) Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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