Risk Factors Associated with Methicillin Resistance among Staphylococcus aureus Infections in Veterans
|
|
- Melvyn Poole
- 6 years ago
- Views:
Transcription
1 infection control and hospital epidemiology january 2010, vol. 31, no. 1 original article Risk Factors Associated with Methicillin Resistance among Staphylococcus aureus s in Veterans Natalie L. McCarthy, MPH; Patrick S. Sullivan, PhD, DVM; Robert Gaynes, MD; David Rimland, MD background. Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging concern in infectious disease practice. Although MRSA infections occur in a wide variety of anatomic sites, the majority of studies considering the risk factors for methicillin resistance among S. aureus infections have focused on MRSA bacteremia. objective. To describe risk factors associated with methicillin resistance among S. aureus infections at different anatomic sites. methods. We collected information on the demographic and clinical characteristics of patients examined at the Atlanta Veterans Affairs Medical Center with S. aureus infections during the period from June 2007 through May We used multivariate logistic regression to describe factors significantly associated with methicillin resistance. results. There were 568 cases of S. aureus infection among 528 patients. We identified 352 cases (62%) of MRSA infection and 216 cases (38%) of methicillin-sensitive S. aureus infection. The adjusted odds of methicillin resistance were higher among infections that occurred among patients who had a prior history of MRSA infection (odds ratio [OR], 3.9 [95% confidence interval {CI}, ]) or resided in a long-term care facility during the past 12 months (OR, 2.0 [95% CI, ]) but were lower for infections that occurred among patients who had undergone a biopsy procedure during the past 12 months (OR, 0.7 [95% CI, ]). Most cases of infection were community-onset infections (523 [92%] of 568 cases), and about one-half (278 [49%]) were not healthcare associated. conclusions. Compared with previous studies of methicillin resistance among patients with S. aureus bacteremia, we found similar factors to be associated with methicillin resistance among S. aureus isolates recovered from more diverse anatomic sites of infection. Of note, nearly one-half of our cases of MRSA infection were not healthcare associated. Infect Control Hosp Epidemiol 2010; 31:36-41 Antibiotic resistance among bacterial pathogens is widely recognized as an emerging issue in infectious disease practice. The National Nosocomial s Surveillance system documented a steady increase in the rate of resistance to antibiotics of Staphylococcus aureus isolates recovered from samples obtained from intensive care unit patients with S. aureus infection during the period from 1998 through Of particular concern is methicillin-resistant S. aureus (MRSA), which has emerged as a major contributor to morbidity and mortality for hospitalized patients. When compared with infections due to methicillin-sensitive S. aureus (MSSA), infections due to MRSA are associated with a significantly higher mortality rate. 2-4 Therefore, it is important to examine the factors that may be associated with MRSA infection and to determine whether associated factors have changed in recent years. Most studies of factors associated with methicillin resistance have focused on bacteremia due to S. aureus. 2-7 Limited data are available for a more heterogeneous group of infections due to S. aureus. 8-9 Our study examined differences in demographic and clinical characteristics between patients with MRSA infection and patients with MSSA infection among all anatomic sites of infection found in a recent cohort. methods We conducted a retrospective exploratory analysis to evaluate the risk factors for methicillin resistance among infections due to S. aureus, for all anatomic sites of infection. The study population consisted of inpatients and outpatients treated at the Atlanta Veterans Affairs Medical Center. Information was collected on all patients with either an MRSA infection or an MSSA infection, or both, diagnosed during the period June 1, 2007, through May 31, MRSA infections and MSSA infections were identified by means of analysis of the database of the microbiology laboratory at the Atlanta Veterans Affairs Medical Center. A line listing of all clinical cultures that grew MRSA and/or MSSA was generated from the computerized patient record system (Vista) at the medical center by using From the Rollins School of Public Health (N.L.M., P.S.S.) and the School of Medicine (R.G., D.R.), Emory University, and the Veterans Affairs Medical Center (R.G., D.R.), Atlanta, Georgia. Received April 2, 2009; accepted July 27, 2009; electronically published November 24, by The Society for Healthcare Epidemiology of America. All rights reserved X/2010/ $ DOI: /649017
2 mrsa and mssa risk factors 37 the microbiology option for specific organisms. Surveillance cultures for nasal colonization, which used samples obtained at admission to the medical center, were excluded from the analysis. Duplicate cultures from the same clinical infection were also excluded. To classify the types of infections, an experienced infectious disease physician (D.R.) reviewed the electronic medical record and used all available information, including anatomic site of culture sampling, radiographic study results, and clinical information, to define a true infection caused by MRSA or MSSA. The physician determined the standards for classifying infections a priori, by use of the Centers for Disease Control and Prevention (CDC) criteria for defining and classifying infections. 10 Cultures not associated with a true infection were not included. A minimum of 30 days between episodes was required to define a separate episode of infection. The infections were then categorized according to anatomic site, in the following categories: skin or soft tissue, bone, bloodstream, urinary tract, respiratory tract, surgical site, ear, sinuses, and other. A x 2 test was used to determine whether there were statistically significant differences in anatomic site of infection between MRSA infections and MSSA infections. We also created a classification for serious infections, which comprised bacteremia and any other infection necessitating hospitalization. We used the CDC definition to classify the infections as hospital-acquired infections, healthcare-associated infections, and community-acquired infections. Hospital-acquired infections were defined as those in which a culture sample obtained 48 hours or more after admission to the hospital yielded a result positive for S. aureus; otherwise, they were considered to be community-onset infections. Healthcareassociated infections, either hospital acquired or community onset, were defined according to the CDC definition as those in which patients had been hospitalized, had undergone surgery or dialysis, resided in a long-term care facility, or used an indwelling catheter during the past 12 months. 11 Information pertinent to the investigation of risk factors was obtained by means of medical chart review. We collected demographic data, including age, race, and sex, and data on risk factors for S. aureus infections, including invasive procedures during the 12 months before the diagnosis of MRSA infection or MSSA infection. Data regarding prior diagnoses of chronic obstructive pulmonary disease (COPD), diabetes mellitus, human immunodeficiency virus (HIV) infection, renal disease, and compromised skin integrity (such as psoriasis, eczema, ulcers, and unspecified cutaneous lesions) were collected. Renal disease was defined as abnormal renal function, documented by a glomerular filtration rate of less than 60, which was calculated using the Cockcroft-Gault formula. 12 Other putative risk factors included the presence of a central venous catheter, residence in a long-term care facility, hospitalization, or a stay in the intensive care unit, all during the 12 months before the index infection. We collected data on any antibiotic use during the 3 months before infection, and any past MRSA infections were also documented. Finally, we collected data on invasive medical procedures undergone during the past 12 months: any biopsy, cardiac catheterization, endoscopy, dialysis, or surgery. We used SAS software, version 9.2 (SAS Institute), to perform the analyses. Descriptive statistics were used to summarize the characteristics of all patients included in the study according to the type of infection (MRSA or MSSA). Since patient age was nonnormally distributed, for each type of infection, we report a median age and interquartile range. We compared serious infections according to type of infection by use of the x 2 test. The Wilcoxon rank sum test was used to compare distributions of age for patients with MRSA infection and patients with MSSA infection. For categorical data, proportions were compared by use of the x 2 test. To build our model, we started with a list of demographic and clinical factors known or suspected to be associated with methicillin resistance. Because all of the variables in the study were potential predictors for methicillin resistance, we considered for the multivariable model only those factors associated with methicillin resistance with a P value of less than.20 in bivariate analysis. To account for patients with multiple infections, we used the GENMOD procedure in SAS (SAS Institute) with an exchangeable covariance matrix to calculate the adjusted odds ratios (ORs) while controlling for repeated observations of patients. We assessed collinearity of all pairs of possible risk factors by use of condition indices and variance decomposition proportions. 13 The backward selection procedure was used to build the final model. At each step, the variable with the highest insignificant P value was removed, and the model was adjusted with the remaining variables. This process continued until each of the variables in the model was significant, with a P value of less than.05, while controlling for the other variables in the model. Once all of the first-order terms for the models were entered, we tested for statistical significance of all 2-way interactions of main effects. We used the logistic regression model to calculate adjusted ORs and 95% confidence intervals (CIs). We conducted a subset analysis that included only the bacteremia infections, to compare our results with those found in other studies. For this analysis, we calculated adjusted ORs by use of a logistic regression model, using similar methods to those described above. However, as a result of the low number of bacteremia infections ( n p 72), we used an a of.10 for bivariate results as a criterion for entry into the multivariate model, and we calculated 90% CIs around the ORs. results During the 1-year study period, there were a total of 785 culture results positive for S. aureus, including duplicates and contaminants. There were 568 cases of S. aureus infection. We identified 352 cases (62%) of MRSA infection and 216 cases (38%) of MSSA infection. There were a total of 528 infected patients, 33 of whom had more than 1 infection
3 38 infection control and hospital epidemiology january 2010, vol. 31, no. 1 table 1. Bivariate Analysis of Selected Risk Factors Associated with Methicillin Resistance in Staphylococcus aureus s among Patients at the Atlanta Veterans Affairs Medical Center, June 2007 May 2008 Patient characteristic due to MRSA (n p 352) due to MSSA (n p 216) P Sex.09 Male 335 (95) 198 (92) Female 17 (5) 18 (8) History of MRSA infection!.001 Yes 113 (32) 14 (6) No 239 (68) 202 (94) Antibiotic use a.04 Yes 151 (43) 74 (34) No 201 (57) 142 (66) Residence in a long-term care facility b.001 Yes 41 (12) 8 (4) No 311 (88) 208 (96) Hospitalized in the past 12 months.03 Yes 130 (37) 61 (28) No 222 (63) 155 (72) Biopsy in the past 12 months.02 Yes 24 (7) 27 (12) No 328 (93) 189 (88) Dialysis in the past 12 months.04 Yes 26(7) 7(3) No 326 (93) 209 (97) COPD c.04 Yes 58(16) 22(10) No 294 (84) 194 (90) Hospital onset d.43 Yes 31 (9) 15 (7) No 321 (91) 201 (93) Healthcare associated e.08 Yes 190 (54) 100 (46) No 162 (46) 116 (54) note. Data are no. (%) of cases. COPD, chronic obstructive pulmonary disease; MRSA, methicillin-resistant S. aureus; MSSA, methicillin-susceptible S. aureus. a During past 3 months. b During past 12 months. c Concurrent with MRSA or MSSA infection. d Culture sample obtained at least 48 hours after hospitalization. e During past 12 months: hospitalization, surgery, receipt of dialysis, residence in a longterm care facility, or use of indwelling catheters. during the study period. Of the 33 patients with more than 1 infection, 24 had multiple MRSA infections, 6 had multiple MSSA infections, and 3 had 1 MSSA infection and also 1 MRSA infection. The large majority of cases of MRSA infection were cases of community-onset infection (ie, 321 [91%] of 352 cases). For cases of MRSA infection and cases of MSSA infection (total, 568 cases), the median age of patients was 60 years (range, years). In 533 (94%) of these 568 cases of infection, the patients were male. In 299 cases (53%), the patients were non-hispanic white; in 253 cases (45%), the patients were non-hispanic black; in 4 cases (1%), the patients were Hispanic; and in 12 cases (2%), the race of the patient was unknown. Table 1 gives the results of the bivariate analysis for the factors found to be associated with methicillin resistance with a P value of less than.20. We did not include race, intensive care unit stay, cardiac catheterization, presence of central venous catheter, use of endoscopy, surgery, diabetes, renal disease, HIV infection, and compromised skin in the model, because they were not associated with methicillin resistance with a P of less than.20. Table 1 also presents the distribution of hospital-onset and healthcare-associated infections among the cases of MRSA infection and the cases of MSSA infection. Table 2 gives the results for the multivariate analysis. Previous MRSA infection (OR, 3.9 [95% CI, ]) and stay in a long-term care facility in the past year (OR, 2.0 [95%
4 mrsa and mssa risk factors 39 table 2. Crude Odds Ratios (ORs) and Adjusted ORs from Multivariate Analysis of Risk Factors Associated with Methicillin Resistance in s Due to Staphylococcus aureus among Patients at the Atlanta Veterans Affairs Medical Center, June 2007 May 2008 Patient characteristic Crude OR (95% CI) Adjusted OR (95% CI) Sex 1.8 ( ) History of MRSA infection 6.8 ( ) 3.9 ( ) Use of antibiotics a 1.4 ( ) Residence in long-term care facility b 3.4 ( ) 2.0 ( ) Past hospitalization b 1.5 ( ) Biopsy b 0.5 ( ) 0.7 ( ) Receipt of dialysis b 2.4 ( ) COPD c 1.7 ( ) note. CI, confidence interval; COPD, chronic obstructive pulmonary disease; MRSA, methicillin-resistant S. aureus. a During past 3 months. b During past 12 months. c Concurrent with study infection. CI, ]) were associated with higher odds of having an MRSA infection, compared with having an MSSA infection. A biopsy in the previous 12 months (OR, 0.7 [95% CI, ]) was associated with lower odds of having an MRSA infection, compared with having an MSSA infection. Approximately one-quarter (13 [25%] of 51) of the biopsies were skin biopsies, and the rest varied among type: liver, foot, rectum, colon, stomach, bladder, dental (extraction of dental fragment), lung, neck node, bone marrow, duodenum, larynx, anus, prostate, pancreas (computed tomography guided biopsy), tongue, neck mass, jaw, nasal septum, kidney, ileum, and nose. No 2-way interaction between main effects was statistically significant in the final model, and therefore none were retained. Table 3 describes the distribution of the anatomic sites of infection. Approximately one-half of the cases of MRSA infection and the cases of MSSA infection were cases of skin or soft-tissue infection, and the rest of the cases of infection varied among the other anatomic sites. Cases of MSSA infection were more likely than cases of MRSA infection to be surgical site infections ( P p.03) or ear infections ( P p.02). There was no significant difference in the proportion of serious infections (defined as cases of bacteremia or infection requiring hospitalization) between cases of MRSA infection and cases of MSSA infection ( P p.87). When we examined only cases of bacteremia due to S. aureus, we found that there were 72 cases of this type of infection, 44 (61%) of which were due to MRSA. Cases of bacteremia were approximately twice as likely to occur among non-hispanic white patients (46 [66%] of 70) as among non- Hispanic black patients (24 [34%] of 70), and none of the cases of bacteremia occurred among Hispanic patients. The age range for patients with bacteremia was years. In the final logistic regression subset analysis of cases of bacteremia, the odds of methicillin resistance among bloodstream infections due to S. aureus were significantly higher for patients with a history of central venous catheter use (OR, 1.9 [90% CI, ]), compromised skin (OR, 2.4 [90% CI, ]), or COPD (OR, 6.4 [90% CI, ]). discussion The results of our study confirmed previously identified risk factors associated with methicillin resistance in S. aureus infections, as well as risk factors associated with MRSA bacteremia specifically. We also noted a lower proportion of healthcare-associated disease than had been expected on the basis of the history of MRSA in healthcare settings We believe that the recent high frequency of community-acquired MRSA infections contributes to the lack of differences between risk factors associated with MRSA infection and risk factors associated with MSSA infection. table 3. Anatomic Sites of Due to Staphylococcus aureus among Patients at the Atlanta Veterans Affairs Medical Center, June 2007 May 2008 Anatomic site due to MRSA (n p 352) due to MSSA (n p 216) P a Skin or soft tissue 187 (53) 99 (46).09 Bone 18 (5) 13 (6).64 Bloodstream 44 (12) 28 (13).87 Urinary tract 49 (14) 22 (10).19 Respiratory tract 16 (5) 11 (5).77 Surgical site 31 (9) 32 (15).03 Ear 1 (0) 5 (2).03 Sinuses 3 (1) 5 (2).16 Other 3 (1) 1 (0).36 note. Data are no. (%) of cases. MRSA, methicillin-resistant S. aureus; MSSA, methicillin-susceptible S. aureus. a P values for the classifications of ear, sinuses, and other were calculated by use of the Fisher exact test; P values for the remaining classifications were calculated by use of the x 2 test.
5 40 infection control and hospital epidemiology january 2010, vol. 31, no. 1 Cases of bacteremia accounted for a limited number of infections in our study. Of the 568 cases of infection due to S. aureus, 496 (87%) were cases of infection other than bacteremia, and 286 (50%) were cases of skin or soft-tissue infection. Thus, we believe that our approach of considering all S. aureus infections gives a broader picture of the risk factors associated with methicillin resistance. Although there was no significant difference between the number of cases of serious infection due to MRSA and the number of cases of serious infection due to MSSA, 187 (33%) of the 568 cases were considered serious (72 cases [13%] were bacteremia, and 115 cases [20%] were cases of other types of infection requiring hospitalization). This evidence indicates that attention should be given to the risk factors for bacteremia due to S. aureus, as well as other types of S. aureus infection. There was a strong association between previous MRSA infection and methicillin resistance for the index infection in our analysis. Our observed OR of 3.9 is consistent with those of other studies, which have found that the odds of having an MRSA infection are approximately 3 4 times greater for patients with a history of MRSA infection than for patients with no history of MRSA infection Residency in a longterm care facility during the past 12 months as a risk factor for MRSA infection is also consistent with the results of other studies. 14,21 The protective association between biopsy and methicillin resistance is an unexplained finding. However, our observed association was weak and was based on a small number of observations and should be interpreted with caution unless others confirm this finding. In the subset analysis of cases of bacteremia, the odds of methicillin resistance were great for infections that occurred in patients with COPD, in patients with a central venous catheter, or in patients with compromised skin. These findings were consistent with those of reports published elsewhere Overall, there were few significant differences between cases of MRSA infection and cases of MSSA infection. This may be due to the fact that we observed more cases of communityacquired MRSA infection than expected, consistent with recent reports In our study, of the 352 cases of MRSA infection, 321 (91%) were cases of community-onset infection and 162 (46%) were cases of community-acquired infection (ie, not healthcare associated according to the CDC definition). MSSA infection is thought to be mostly a communityassociated disease; however, in our study, nearly one-half of both types of S. aureus infection (methicillin resistant and methicillin susceptible) were community acquired. The appearance of both types of infection in the community may explain the limited distinction in healthcare-related risk factors between MRSA infection and MSSA infection, as others have previously reported elsewhere. 27,29,30 In addition, relatively few cases of MRSA infection (31 [9%] of 352) actually occurred in the hospital. These findings may have implications for the success of the MRSA prevention and control efforts recently advocated for hospitals. 31 There are some limitations to our study. Because we collected our data through medical chart review, we were limited in the types of data we could collect. Data on exposures that may have occurred in the community, such as contact with people with infections due to S. aureus, were not systematically collected or recorded in the medical records and therefore could not be considered in our analysis. In addition, because this was a retrospective study, there is a possibility of information bias in the collection of historical information from medical records. There is also a chance of selection bias, in that some patients with MRSA infection or MSSA infection may not have been tested by culture but were treated empirically without a diagnostic test. These infections would not be included in the study, so we may have underestimated the true burden of disease. If such bias in culturing was differential, in which certain types of infections were more likely to be submitted for culture by clinicians, then our data on the characteristics of infections might also be affected. Because these data were collected in a specialized clinical population (veterans), the findings cannot be generalized to the US population. Finally, the absence of culture testing for analysis of molecular subtype limits the ability to distinguish community-acquired infections from healthcare-associated infections according to molecular criteria. This last issue has become less relevant, as mixtures of both resistance patterns are now seen in the community and in healthcare settings. In conclusion, previous MRSA infection and residency in a long-term care facility were significantly associated with a greater risk of MRSA infection than MSSA infection. A biopsy procedure in the past year had a weak association with MSSA infection and should be considered for further study with a larger population. The risk factors for MRSA infection were not as distinct from those of MSSA infection, as described elsewhere. We believe that the striking increase in community-acquired MRSA infections explains the similarities in clinical history between MRSA infections and MSSA infections in our cohort. acknowledgments Financial support. Centers for Disease Control and Prevention (grant 07FED706507). Potential conflicts of interest. All authors report no conflicts of interest relevant to this article. Address reprint requests to David Rimland, MD, Medical Specialty Service Line (111-RIM), Veterans Affairs Medical Center, 1670 Clairmont Road, Decatur, GA (david.rimland@va.gov). references 1. National Nosocomial s Surveillance (NNIS) system report, data summary from January 1992 through June 2004, issued October Am J Infect Control 2004; 32: Cosgrove SE, Sakoulas G, Perencevich EN, Schwaber MJ, Karchmer AW, Carmeli Y. Comparison of mortality associated with methicillin-resistant and methicillin-suceptible Staphylococcus aureus bacteremia: a meta-analysis. Clin Infect Dis 2003; 36: Blot SI, Vandewoude KH, Hoste EA, Colardyn FA. Outcome and at-
6 mrsa and mssa risk factors 41 tributable mortality in critically ill patients with bacteremia involving methicillin-susceptible and methicillin-resistant Staphylococcus aureus. Arch Intern Med 2002; 162: Shurland S, Zhan M, Bradham DD, Roghmnn M. Comparison of mortality risk associated with bacteremia due to methicillin-resistant and methicillin-susceptible Staphylococcus aureus. Infect Control Hosp Epidemiol 2007; 28: Wang J, Chen S, Wang J, et al. Comparison of both clinical features and mortality risk associated with bacteremia due to community-acquired methicillin-resistant Staphylococcus aureus and methicillin-susceptible S. aureus. Clin Infect Dis 2008; 46: Gonzalez C, Rubio M, Romero-Vivas J, Gonzalez M, Picazo JJ. Bacteremic pneumonia due to Staphylococcus aureus: a comparison of disease caused by methicillin-resistant and methicillin-susceptible organisms. Clin Infect Dis 1999; 29: Laupland KB, Ross T, Gregson DB. Staphylococcus aureus bloodstream infections: risk factors, outcomes, and the influence of methicillin resistance in Calgary, Canada, J Infect Dis 2008; 198: Sadoyama G, Gontijo Filho PP. Risk factors for methicillin resistant and sensitive Staphylococcus aureus infection in a Brazilian university hospital. Braz J Infect Dis 2000; 4: Munckhof WJ, Nimmo GR, Carney J, et al. Methicillin-susceptible, nonmultiresistant methicillin-resistant and multiresistant methicillin-resistant Staphylococcus aureus infections: a clinical, epidemiological and microbiological comparative study. Eur J Clin Microbiol Infect Dis 2008; 27: Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008; 36: Klevens RM, Morrison MA, Fridkin SK, et al. Community-associated methicillin-resistant Staphylococcus aureus and healthcare risk factors. Emerg Infect Dis 2006; 12: Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976; 16: Kleinbaum DG, Klein M. Logistic Regression: A Self-Learning Text. 2nd ed. New York, NY: Springer; Jorgensen JH. Laboratory and epidemiologic experience with methicillin-resistant Staphylococcus aureus in the United States. Eur J Clin Microbiol 1986; 5: Wenzel RP, Nettleman MD, Jones RN, Pfaller MA. Methicillin-resistant Staphylococcus aureus: implications for the 1990s and effective control measures. AmJMed1991; 91(Suppl 3B):221S 227S. 16. Mulligan ME, Murray-Leisure KA, Ribner BS, et al. Methicillin-resistant Staphylococcus aureus: a consensus review of the microbiology, pathogenesis, and epidemiology with implications for prevention and management. AmJMed1995; 98: Haley CC, Mittal D, LaViolette A, Jannapureddy S, Parvez N, Haley RW. Methicillin-resistant Staphylococcus aureus infection or colonization present at hospital admission: multivariable risk factor screening to increase efficiency of surveillance culturing. J Clin Microbiol 2007; 45: Moran GJ, Krishnadasan A, Gorwitz RJ, et al. Methicillin-resistant S. aureus infections among patients in the emergency department. N Engl J Med 2006; 355: Huang SS, Platt R. Risk of methicillin-resistant Staphylococcus aureus infection after previous infection or colonization. Clin Infect Dis 2003; 36: Beam JW, Buckley B. Community-acquired methicillin-resistant Staphylococcus aureus: prevalence and risk factors. J Athl Train 2006; 41: Bradley S, Terpenning MS, Ramsey MA, et al. Methicillin-resistant Staphylococcus aureus: colonization and infection in a long-term care facility. Ann Intern Med 1991; 115: Bakowski E, Wey SB, Medeiros EAS. Risk factors for bacteremia and predictors of mortality of patients with bloodstream infection with methicillin-resistant Staphylococcus aureus. Am J Infect Dis 2008; 4: Wang F, Chen Y, Chen T, Liu C. Risk factors and mortality in patients with nosocomial Staphylococcus aureus bacteremia. Am J Infect Control 2008; 36: Chi C, Wong W, Fung C, Yu K, Liu C. Epidemiology of community-acquired Staphylococcus aureus bacteremia. J Microbiol Immunol Infect 2004; 37: Lowy FD, Aiello AE, Bha M, et al. Staphylococcus aureus colonization and infection in New York state prisons. J Infect Dis 2007; 196: Vanden F, Naimi T, Enright MC, et al. Community-acquired methicillinresistant Staphylococcus aureus carrying Panton-Valentine leukocidin genes: worldwide emergence. Emerg Infect Dis 2003; 9: Miller LG, Perdreau-Remington F, Bayer AS, et al. Clinical and epidemiologic characteristics cannot distinguish community-associated methicillin-resistant Staphylococcus aureus infection from methicillin-susceptible S. aureus infection: a prospective investigation. Clin Infect Dis 2007; 44: Crum NF, Lee RU, Thornton SA, et al. Fifteen-year study of the changing epidemiology of methicillin-resistant Staphylococcus aureus. Am J Med 2006; 119: Diederen BMW, Kluytmans JAJW. The emergence of infections with community-associated methicillin resistant Staphylococcus aureus. J Infect 2006; 52: Rollason J, Bastin L, Hilton AC, et al. Epidemiology of community-acquired methicillin-resistant Staphylococcus aureus obtained from the UK West Midlands region. J Hosp Infect 2008; 70: Muto C, Jerigan J, Ostrowsky B, et al. SHEA guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and Enterococcus. Infect Control Hosp Epidemiol 2003; 24:
Risk factors for methicillin-resistant Staphylococcus aureus bacteraemia differ depending on the control group chosen
Epidemiol. Infect. (2013), 141, 2376 2383. Cambridge University Press 2013 doi:10.1017/s0950268813000174 Risk factors for methicillin-resistant Staphylococcus aureus bacteraemia differ depending on the
More informationEvaluating the Role of MRSA Nasal Swabs
Evaluating the Role of MRSA Nasal Swabs Josh Arnold, PharmD PGY1 Pharmacy Resident Pharmacy Grand Rounds February 28, 2017 2016 MFMER slide-1 Objectives Identify the pathophysiology of MRSA nasal colonization
More informationRisk Factors for Persistent MRSA Colonization in Children with Multiple Intensive Care Unit Admissions
University of Massachusetts Amherst From the SelectedWorks of Nicholas G Reich July, 2013 Risk Factors for Persistent MRSA Colonization in Children with Multiple Intensive Care Unit Admissions Victor O.
More informationDoes Screening for MRSA Colonization Have A Role In Healthcare-Associated Infection Prevention Programs?
Does Screening for MRSA Colonization Have A Role In Healthcare-Associated Infection Prevention Programs? John A. Jernigan, MD, MS Division of Healthcare Quality Promotion Centers for Disease Control and
More informationActive Bacterial Core Surveillance Site and Epidemiologic Classification, United States, 2005a. Copyright restrictions may apply.
Impact of routine surgical ward and intensive care unit admission surveillance cultures on hospital-wide nosocomial methicillin-resistant Staphylococcus aureus infections in a university hospital: an interrupted
More informationSource: Portland State University Population Research Center (
Methicillin Resistant Staphylococcus aureus (MRSA) Surveillance Report 2010 Oregon Active Bacterial Core Surveillance (ABCs) Office of Disease Prevention & Epidemiology Oregon Health Authority Updated:
More informationFM - Male, 38YO. MRSA nasal swab (+) Due to positive MRSA nasal swab test, patient will be continued on Vancomycin 1500mg IV q12 for MRSA treatment...
Jillian O Keefe Doctor of Pharmacy Candidate 2016 September 15, 2015 FM - Male, 38YO HPI: Previously healthy male presents to ED febrile (102F) and in moderate distress ~2 weeks after getting a tattoo
More informationMethicillin-Resistant Staphylococcus aureus Nasal Swabs as a Tool in Antimicrobial Stewardship
Methicillin-Resistant Staphylococcus aureus Nasal Swabs as a Tool in Antimicrobial Stewardship Natalie R. Tucker, PharmD Antimicrobial Stewardship Pharmacist Tyson E. Dietrich, PharmD PGY2 Infectious Diseases
More informationEpidemiology of early-onset bloodstream infection and implications for treatment
Epidemiology of early-onset bloodstream infection and implications for treatment Richard S. Johannes, MD, MS Marlborough, Massachusetts Health care-associated infections: For over 35 years, infections
More informationInappropriate Use of Antibiotics and Clostridium difficile Infection. Jocelyn Srigley, MD, FRCPC November 1, 2012
Inappropriate Use of Antibiotics and Clostridium difficile Infection Jocelyn Srigley, MD, FRCPC November 1, 2012 Financial Disclosures } No conflicts of interest } The study was supported by a Hamilton
More informationSummary Report Relating to a Pilot Program to Require Reporting of Methicillin-resistant Staphylococcus aureus
Summary Report Relating to a Pilot Program to Require Reporting of Methicillin-resistant Staphylococcus aureus Prepared by the Texas Department of State Health Services as required by House Bill 1082,
More informationImpact of a Standardized Protocol to Address Outbreak of Methicillin-resistant
Impact of a Standardized Protocol to Address Outbreak of Methicillin-resistant Staphylococcus Aureus Skin Infections at a large, urban County Jail System Earl J. Goldstein, MD* Gladys Hradecky, RN* Gary
More informationBurden of disease of antibiotic resistance The example of MRSA. Eva Melander Clinical Microbiology, Lund University Hospital
Burden of disease of antibiotic resistance The example of MRSA Eva Melander Clinical Microbiology, Lund University Hospital Discovery of antibiotics Enormous medical gains Significantly reduced morbidity
More informationSURVEILLANCE AND INFECTION CONTROL IN AN INTENSIVE CARE UNIT
Vol. 26 No. 3 INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY 1 SURVEILLANCE AND INFECTION CONTROL IN AN INTENSIVE CARE UNIT Giovanni Battista Orsi, MD; Massimiliano Raponi, MD; Cristiana Franchi, MD; Monica
More informationAmerican Journal of Infection Control
American Journal of Infection Control xxx (2013) 1-5 Contents lists available at ScienceDirect American Journal of Infection Control American Journal of Infection Control journal homepage: www.ajicjournal.org
More informationIDSA GUIDELINES COMMUNITY ACQUIRED PNEUMONIA
page 1 / 5 page 2 / 5 idsa guidelines community acquired pdf IDSA/ATS Guidelines for CAP in Adults CID 2007:44 (Suppl 2) S29 such as blood and sputum cultures. Conversely, these cultures may have a major
More informationHealthcare-associated Infections Annual Report March 2015
March 2015 Healthcare-associated Infections Annual Report 2009-2014 TABLE OF CONTENTS SUMMARY... 1 MRSA SURVEILLANCE RESULTS... 1 CDI SURVEILLANCE RESULTS... 1 INTRODUCTION... 2 METHICILLIN-RESISTANT
More informationIsolation of MRSA from the Oral Cavity of Companion Dogs
InfectionControl.tips Join. Contribute. Make A Difference. https://infectioncontrol.tips Isolation of MRSA from the Oral Cavity of Companion Dogs By: Thomas L. Patterson, Alberto Lopez, Pham B Reviewed
More informationAnnual Surveillance Summary: Methicillinresistant Staphylococcus aureus (MRSA) Infections in the Military Health System (MHS), 2017
Annual Surveillance Summary: Methicillinresistant Staphylococcus aureus (MRSA) Infections in the Military Health System (MHS), 2017 Jessica R. Spencer and Uzo Chukwuma Approved for public release. Distribution
More informationScreening programmes for Hospital Acquired Infections
Screening programmes for Hospital Acquired Infections European Diagnostic Manufacturers Association In Vitro Diagnostics Making a real difference in health & life quality June 2007 HAI Facts Every year,
More informationWhy should we care about multi-resistant bacteria? Clinical impact and
Why should we care about multi-resistant bacteria? Clinical impact and public health implications Prof. Stephan Harbarth Infection Control Program Geneva, Switzerland and Ebola (in 2014/2015) Increased
More informationMethicillin-Resistant Staphylococcus aureus (MRSA) Infections Activity C: ELC Prevention Collaboratives
Methicillin-Resistant Staphylococcus aureus (MRSA) Infections Activity C: ELC Prevention Collaboratives John Jernigan, MD, MS Alex Kallen, MD, MPH Division of Healthcare Quality Promotion Centers for Disease
More informationRisk of organism acquisition from prior room occupants: A systematic review and meta analysis
Risk of organism acquisition from prior room occupants: A systematic review and meta analysis A/Professor Brett Mitchell 1-2 Dr Stephanie Dancer 3 Dr Malcolm Anderson 1 Emily Dehn 1 1 Avondale College;
More informationFollow this and additional works at:
University of Massachusetts Amherst ScholarWorks@UMass Amherst Masters Theses Dissertations and Theses 2014 Penicillin Use and Duration of Bacteremia, Length of Stay, and 30-day Readmission in Hospitalized
More informationDATA COLLECTION SECTION BY FRONTLINE TEAM. Patient Identifier/ Medical Record number (for facility use only)
Assessment of Appropriateness of ICU Antibiotics (Patient Level Sheet) **Note this is intended for internal purposes only. Please do not return to PQC.** For this assessment, inappropriate antibiotic use
More informationGUIDE TO INFECTION CONTROL IN THE HOSPITAL
GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER 43: Staphylococcus Aureus Authors J. Pierce, MD M. Edmond, MD, MPH, MPA M.P. Stevens, MD, MPH Chapter Editor Michelle Doll, MD, MPH) Topic Outline Key
More informationA Prospective Investigation of Nasal Mupirocin, Hexachlorophene Body Wash, and Systemic
AAC Accepts, published online ahead of print on 14 November 2011 Antimicrob. Agents Chemother. doi:10.1128/aac.01608-10 Copyright 2011, American Society for Microbiology and/or the Listed Authors/Institutions.
More informationInstitutional and Patient Level Predictors of Multi-Drug Resistant Healthcare- Associated Infections. Monika Pogorzelska
Institutional and Patient Level Predictors of Multi-Drug Resistant Healthcare- Associated Infections Monika Pogorzelska Submitted in partial fulfillment of the requirements for the degree of Doctor of
More informationInfection Control Manual Residential Care Part 3 Infection Control Standards IC7: 0100 Methicillin Resistant Staphylococcus aureus
Infection Control Manual Residential Care Part 3 Infection Control Standards IC7: 0100 Methicillin Resistant Staphylococcus aureus IC7: 0100 MRSA 1. Purpose To outline the assessment, management, room
More informationStaphylococcus Aureus
GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER 43: Staphylococcus Aureus Authors J. Pierce, MD M. Edmond, MD, MPH, MPA M.P. Stevens, MD, MPH Chapter Editor Michelle Doll, MD, MPH) Topic Outline Key
More information8/17/2016 ABOUT US REDUCTION OF CLOSTRIDIUM DIFFICILE THROUGH THE USE OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM
Mary Moore, MS CIC MT (ASCP) Infection Prevention Coordinator Great River Medical Center, West Burlington REDUCTION OF CLOSTRIDIUM DIFFICILE THROUGH THE USE OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM ABOUT
More informationAnnual Surveillance Summary: Methicillin- Resistant Staphylococcus aureus (MRSA) Infections in the Military Health System (MHS), 2016
Annual Surveillance Summary: Methicillin- Resistant Staphylococcus aureus (MRSA) Infections in the Military Health System (MHS), 2016 Jessica Spencer and Uzo Chukwuma Approved for public release. Distribution
More informationKonsequenzen für Bevölkerung und Gesundheitssysteme. Stephan Harbarth Infection Control Program
Konsequenzen für Bevölkerung und Gesundheitssysteme Stephan Harbarth Infection Control Program University of Geneva Hospitals Outline Introduction What data sources are available? AMR-associated outcomes
More informationHorizontal vs Vertical Infection Control Strategies
GUIDE TO INFECTION CONTROL IN THE HOSPITAL Chapter 14 Horizontal vs Vertical Infection Control Strategies Author Salma Abbas, MBBS Michael Stevens, MD, MPH Chapter Editor Shaheen Mehtar, MBBS. FRC Path,
More informationHealthcare-associated Infections Annual Report
September 2014 Healthcare-associated Infections Annual Report 2009-2013 Summary Provincial Infection Control Newfoundland Labrador (PIC-NL) has collected data on inpatients and outpatients with healthcare-associated
More informationAbstract. Introduction. Editor: M. Paul
ORIGINAL ARTICLE BACTERIOLOGY Knowing prior methicillin-resistant Staphylococcus aureus (MRSA) infection or colonization status increases the empirical use of glycopeptides in MRSA bacteraemia and may
More informationTACKLING THE MRSA EPIDEMIC
TACKLING THE MRSA EPIDEMIC Paul D. Holtom, MD Associate Professor of Medicine and Orthopaedics USC Keck School of Medicine MRSA Trend (HA + CA) in US TSN Database USA (1993-2003) % of MRSA among S. aureus
More informationSuccess for a MRSA Reduction Program: Role of Surveillance and Testing
Success for a MRSA Reduction Program: Role of Surveillance and Testing Singapore July 13, 2009 Lance R. Peterson, MD Director of Microbiology and Infectious Disease Research Associate Epidemiologist, NorthShore
More informationThe importance of infection control in the era of multi drug resistance
Dr. Kumar Consultant Infectious Diseases Physician Hospital Sungai buloh The importance of infection control in the era of multi drug resistance Nosocomial infections In Australian acute hospitals 200,000
More informationTREAT Steward. Antimicrobial Stewardship software with personalized decision support
TREAT Steward TM Antimicrobial Stewardship software with personalized decision support ANTIMICROBIAL STEWARDSHIP - Interdisciplinary actions to improve patient care Quality Assurance The aim of antimicrobial
More informationStaphylococcus aureus Bacteremia: Comparison of Two Periods and a Predictive Model of Mortality
288 BJID 2002; 6 (December) Staphylococcus aureus Bacteremia: Comparison of Two Periods and a Predictive Model of Mortality Lucieni de Oliveira Conterno, Sérgio Barsanti Wey and Adauto Castelo Division
More informationSurveillance of Multi-Drug Resistant Organisms
Surveillance of Multi-Drug Resistant Organisms Karen Hoffmann, RN, MS, CIC Associate Director Statewide Program for Infection Control and Epidemiology (SPICE) University of North Carolina School of Medicine
More informationChallenges and opportunities for rapidly advancing reporting and improving inpatient antibiotic use in the U.S.
Challenges and opportunities for rapidly advancing reporting and improving inpatient antibiotic use in the U.S. Overview of benchmarking Antibiotic Use Scott Fridkin, MD, Senior Advisor for Antimicrobial
More informationMeredith C. Faires, Michelle Traverse, Kathy C. Tater, David L. Pearl, and J. Scott Weese
Methicillin-Resistant and -Susceptible Staphylococcus aureus Infections in Dogs Meredith C. Faires, Michelle Traverse, Kathy C. Tater, David L. Pearl, and J. Scott Weese Methicillin-resistant Staphylococcus
More informationIs Cefazolin Inferior to Nafcillin for Treatment of Methicillin-Susceptible Staphylococcus aureus Bacteremia?
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Nov. 2011, p. 5122 5126 Vol. 55, No. 11 0066-4804/11/$12.00 doi:10.1128/aac.00485-11 Copyright 2011, American Society for Microbiology. All Rights Reserved. Is Cefazolin
More informationLindsay E. Nicolle University of Manitoba Winnipeg, CANADA
Lindsay E. Nicolle University of Manitoba Winnipeg, CANADA Long Term Care Facilities: Spectrum low acuity assisted living mobile independent Not LTAC high acuity complete functional disability dialysis
More informationHealthcare-associated infections surveillance report
Healthcare-associated infections surveillance report Methicillin-resistant Staphylococcus aureus (MRSA) Update, Q4 2015/16 Summary Table Q4 2015/2016 Previous quarter (Q3 2015/16) Same quarter of previous
More informationPreventing Multi-Drug Resistant Organism (MDRO) Infections. For National Patient Safety Goal
Preventing Multi-Drug Resistant Organism (MDRO) Infections For National Patient Safety Goal 07.03.01 2009 Methicillin Resistant Staphlococcus aureus (MRSA) About 3-8% of the population at large is a carrier
More informationMeasure Information Form
Release Notes: Measure Information Form Version 3.0b **NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE** Measure Set: Pneumonia (PN) Performance Measure Identifier: Measure Information Form
More informationORIGINAL INVESTIGATION. Increasing Outpatient Fluoroquinolone Exposure Before Tuberculosis Diagnosis and Impact on Culture-Negative Disease
ORIGINAL INVESTIGATION Increasing Outpatient Fluoroquinolone Exposure Before Tuberculosis Diagnosis and Impact on Culture-Negative Disease Pinky D. Gaba, MD; Connie Haley, MD, MPH; Marie R. Griffin, MD,
More information4/3/2017 CLINICAL PEARLS: UPDATES IN THE MANAGEMENT OF NOSOCOMIAL PNEUMONIA DISCLOSURE LEARNING OBJECTIVES
CLINICAL PEARLS: UPDATES IN THE MANAGEMENT OF NOSOCOMIAL PNEUMONIA BILLIE BARTEL, PHARMD, BCCCP APRIL 7 TH, 2017 DISCLOSURE I have had no financial relationship over the past 12 months with any commercial
More informationCompliance with antibiotic treatment guidelines in managed care patients with communityacquired pneumonia in ambulatory settings
Compliance with antibiotic treatment guidelines in managed care patients with communityacquired pneumonia in ambulatory settings Jasmanda H. Wu, Ph.D., 1 David H. Howard, Ph.D., 2 John E. McGowan, Jr.,
More informationIMPLEMENTATION AND ASSESSMENT OF A GUIDELINE-BASED TREATMENT ALGORITHM FOR COMMUNITY-ACQUIRED PNEUMONIA (CAP)
IMPLEMENTATION AND ASSESSMENT OF A GUIDELINE-BASED TREATMENT ALGORITHM FOR COMMUNITY-ACQUIRED PNEUMONIA (CAP) Lucas Schonsberg, PharmD PGY-1 Pharmacy Practice Resident Providence St. Patrick Hospital Missoula,
More information11-ID-10. Committee: Infectious Disease. Title: Creation of a National Campylobacteriosis Case Definition
11-ID-10 Committee: Infectious Disease Title: Creation of a National Campylobacteriosis Case Definition I. Statement of the Problem Although campylobacteriosis is not nationally-notifiable, it is a disease
More informationOverview of Nosocomial Infections Caused by Gram-Negative Bacilli
HEALTHCARE EPIDEMIOLOGY Robert A. Weinstein, Section Editor INVITED ARTICLE Overview of Nosocomial Infections Caused by Gram-Negative Bacilli Robert Gaynes, Jonathan R. Edwards, and the National Nosocomial
More information03/09/2014. Infection Prevention and Control A Foundation Course. Talk outline
Infection Prevention and Control A Foundation Course 2014 What is healthcare-associated infection (HCAI), antimicrobial resistance (AMR) and multi-drug resistant organisms (MDROs)? Why we should be worried?
More informationCombination vs Monotherapy for Gram Negative Septic Shock
Combination vs Monotherapy for Gram Negative Septic Shock Critical Care Canada Forum November 8, 2018 Michael Klompas MD, MPH, FIDSA, FSHEA Professor, Harvard Medical School Hospital Epidemiologist, Brigham
More informationCommunity-Onset Methicillin-Resistant Staphylococcus aureus Skin and Soft-Tissue Infections: Impact of Antimicrobial Therapy on Outcome
MAJOR ARTICLE Community-Onset Methicillin-Resistant Staphylococcus aureus Skin and Soft-Tissue Infections: Impact of Antimicrobial Therapy on Outcome Jörg J. Ruhe, 1,2 Nathaniel Smith, 1,3 Robert W. Bradsher,
More informationTITLE: Recognition and Diagnosis of Sepsis in Rural or Remote Areas: A Review of Clinical and Cost-Effectiveness and Guidelines
TITLE: Recognition and Diagnosis of Sepsis in Rural or Remote Areas: A Review of Clinical and Cost-Effectiveness and Guidelines DATE: 11 August 2016 CONTEXT AND POLICY ISSUES Sepsis, defined in the 2016
More informationAntimicrobial Cycling. Donald E Low University of Toronto
Antimicrobial Cycling Donald E Low University of Toronto Bad Bugs, No Drugs 1 The Antimicrobial Availability Task Force of the IDSA 1 identified as particularly problematic pathogens A. baumannii and
More informationPredictors of the Diagnosis and Antibiotic Prescribing to Patients Presenting with Acute Respiratory Infections
Predictors of the Diagnosis and Antibiotic Prescribing to Patients Presenting with Acute Respiratory Infections BY RYAN JOERRES CAPSTONE COMMITTEE MEMBERS: DENNIS J. BAUMGARDNER, MD, AJAY K. SETHI, PH.D.,
More informationClostridium difficile Surveillance Report 2016
Clostridium difficile Surveillance Report 2016 EMERGING INFECTIONS PROGRAM Clostridium difficile Surveillance Report 2016 Minnesota Department of Health Emerging Infections Program PO Box 64882, St. Paul,
More informationGUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS
Version 3.1 GUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS Date ratified June 2008 Updated March 2009 Review date June 2010 Ratified by Authors Consultation Evidence base Changes
More informationLin M. Riccio, Kimberley A. Popovsky, Tjasa Hranjec, Amani D. Politano, Laura H. Rosenberger, Kristin C. Tura, and Robert G.
SURGICAL INFECTIONS Volume 15, Number 4, 2014 ª Mary Ann Liebert, Inc. DOI: 10.1089/sur.2012.077 Association of Excessive Duration of Antibiotic Therapy for Intra-Abdominal Infection with Subsequent Extra-Abdominal
More informationORIGINAL ARTICLE. Xiaoyan Song 1,2, Jonathan Cogen 3 and Nalini Singh 1,2
(2013) 2, e69; doi:10.1038/emi.2013.69 ß 2013 SSCC. All rights reserved 2222-1751/13 www.nature.com/emi ORIGINAL ARTICLE Incidence of methicillin-resistant Staphylococcus aureus infection in a children
More informationApproval Signature: Original signed by Dr. Michel Tetreault Date of Approval: July Review Date: July 2017
WRHA Infection Prevention and Control Program Operational Directives Admission Screening for Antibiotic Resistant Organisms (AROs): Methicillin Resistant Staphylococcus aureus (MRSA) and Vancomycin Resistant
More informationTargeted MRSA Surveillance and its Potential Use to Guide Empiric Antibiotic Therapy
AAC Accepts, published online ahead of print on 17 May 2010 Antimicrob. Agents Chemother. doi:10.1128/aac.01590-09 Copyright 2010, American Society for Microbiology and/or the Listed Authors/Institutions.
More informationEpidemiology of community-acquired Staphylococcus aureus bacteremia
Community-acquired J Microbiol Immunol Infect Staphylococcus aureus bacteremia 2004;37:16-23 Epidemiology of community-acquired Staphylococcus aureus bacteremia Chih-Yu Chi 1, Wing-Wai Wong 1, Chang-Phone
More informationAntimicrobial stewardship: Quick, don t just do something! Stand there!
Antimicrobial stewardship: Quick, don t just do something! Stand there! Stanley I. Martin, MD, FACP, FIDSA Director, Division of Infectious Diseases Director, Antimicrobial Stewardship Program Geisinger
More informationImpact of Postoperative Antibiotic Prophylaxis Duration on Surgical Site Infections in Autologous Breast Reconstruction
Impact of Postoperative Antibiotic Prophylaxis Duration on Surgical Site Infections in Autologous Breast Reconstruction Kerry E. Drury, BA 1 ; Steven T. Lanier, MD 1 ; Nima Khavanin, BS 1 ; Keith M. Hume,
More informationStaphylococcus aureus Bacteremia, Australia
RESEARCH Staphylococcus aureus Bacteremia, Australia Peter Collignon,* Graeme R. Nimmo, Thomas Gottlieb, and Iain B. Gosbell, on behalf of the Australian Group on Antimicrobial Resistance 1 Staphylococcus
More informationNosocomial Infections: What Are the Unmet Needs
Nosocomial Infections: What Are the Unmet Needs Jean Chastre, MD Service de Réanimation Médicale Hôpital Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie, Paris 6, France www.reamedpitie.com
More informationHealthcare-associated Infections Annual Report December 2018
December 2018 Healthcare-associated Infections Annual Report 2011-2017 TABLE OF CONTENTS INTRODUCTION... 1 METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS INFECTIONS... 2 MRSA SURVEILLANCE... 3 CLOSTRIDIUM
More informationHEALTHCARE-ACQUIRED INFECTIONS AND ANTIMICROBIAL RESISTANCE
Universidade de São Paulo Departamento de Moléstias Infecciosas e Parasitárias HEALTHCARE-ACQUIRED INFECTIONS AND ANTIMICROBIAL RESISTANCE Anna S. Levin 4 main lines! Epidemiology of HAS and resistance!
More informationDuring the second half of the 19th century many operations were developed after anesthesia
Continuing Education Column Surgical Site Infection and Surveillance Tae Jin Lim, MD Department of Surgery, Keimyung University College of Medicine E mail : tjlim@dsmc.or.kr J Korean Med Assoc 2007; 50(10):
More informationMeasure Information Form Collected For: CMS Voluntary Only The Joint Commission - Retired
Measure Information Form Collected For: CMS Voluntary Only The Joint Commission - Retired Last Updated: Version 4.3a Measure Set: Pneumonia (PN) Set Measure I #: Performance Measure Name: lood Cultures
More informationStaphylococcus aureus Bloodstream Infections: Risk Factors, Outcomes, and the Influence of Methicillin Resistance in Calgary, Canada,
MAJOR ARTICLE Staphylococcus aureus Bloodstream Infections: Risk Factors, Outcomes, and the Influence of Methicillin Resistance in Calgary, Canada, 2000 2006 Kevin B. Laupland, 1,2,3,4 Terry Ross, 3,4
More informationOriginal Articles. K A M S W Gunarathne 1, M Akbar 2, K Karunarathne 3, JRS de Silva 4. Sri Lanka Journal of Child Health, 2011; 40(4):
Original Articles Analysis of blood/tracheal culture results to assess common pathogens and pattern of antibiotic resistance at medical intensive care unit, Lady Ridgeway Hospital for Children K A M S
More informationStaphylococcus aureus Blood Stream Infection (Bacteraemia) Surveillance. Ceredigion and Mid Wales Trust Data per Bed Days
Staphylococcus aureus Blood Stream Infection (Bacteraemia) Surveillance Ceredigion and Mid Wales Trust Data per 100 000 Bed Days Commentary: Staphylococcus aureus is a bacterium that a proportion (up to
More informationThe Impact of meca Gene Testing and Infectious Diseases Pharmacists. Intervention on the Time to Optimal Antimicrobial Therapy for ACCEPTED
JCM Accepts, published online ahead of print on 7 May 2008 J. Clin. Microbiol. doi:10.1128/jcm.00801-08 Copyright 2008, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights
More information1/30/ Division of Disease Control and Health Protection. Division of Disease Control and Health Protection
Surveillance, Outbreaks, and Reportable Diseases, Oh My! Assisted Living Facility, Nursing Home and Surveyor Infection Prevention Training February 2015 A.C. Burke, MA, CIC Health Care-Associated Infection
More informationNewsflash: Hospital Medicine JOHN C. CHRISTENSEN, MD FACP AMERICAN COLLEGE OF PHYSICIANS, UTAH CHAPTER SCIENTIFIC MEETING FEBRUARY 10, 2017
Newsflash: Hospital Medicine JOHN C. CHRISTENSEN, MD FACP AMERICAN COLLEGE OF PHYSICIANS, UTAH CHAPTER SCIENTIFIC MEETING FEBRUARY 10, 2017 Newsflash: Fluoroquinolones Newsflash: Fluoroquinolones Don t
More informationEradiaction of Resistant Organisms:
Eradiaction of Resistant Organisms: Can we do it and does it help? Noah Lechtzin, MD; MHS Director, Adult CF Program Outline Evidence resistant organisms are bad MRSA, B cepacia, Pseudomonas, Fungal infections
More informationIowa Research Online. University of Iowa. Justin Paul Albertson University of Iowa. Theses and Dissertations. Spring 2014
University of Iowa Iowa Research Online Theses and Dissertations Spring 2014 Development and validation of a prediction rule for methicillin-resistant Staphylococcus aureus recurrent infection among a
More informationIcd 10 code for bacteremia with mssa
Icd 10 code for bacteremia with mssa The Borg System is 100 % Icd 10 code for bacteremia with mssa ICD-10: R78.81 Short Description: Bacteremia Long Description: Bacteremia This is the 2018 version of
More informationChanging epidemiology of methicillin-resistant Staphylococcus aureus colonization in paediatric intensive-care units
Washington University School of Medicine Digital Commons@Becker Open Access Publications 2012 Changing epidemiology of methicillin-resistant Staphylococcus aureus colonization in paediatric intensive-care
More informationRapid molecular testing to detect Staphylococcus aureus in positive blood cultures improves patient management. Martin McHugh Clinical Scientist
Rapid molecular testing to detect Staphylococcus aureus in positive blood cultures improves patient management Martin McHugh Clinical Scientist 1 Staphylococcal Bacteraemia SAB is an important burden on
More informationAntibiotic usage in nosocomial infections in hospitals. Dr. Birgit Ross Hospital Hygiene University Hospital Essen
Antibiotic usage in nosocomial infections in hospitals Dr. Birgit Ross Hospital Hygiene University Hospital Essen Infection control in healthcare settings - Isolation - Hand Hygiene - Environmental Hygiene
More informationA retrospective analysis of urine culture results issued by the microbiology department, Teaching Hospital, Karapitiya
A retrospective analysis of urine culture results issued by the microbiology department, Teaching Hospital, Karapitiya LU Edirisinghe 1, D Vidanagama 2 1 Senior Registrar in Medicine, 2 Consultant Microbiologist,
More informationAppropriate antimicrobial therapy in HAP: What does this mean?
Appropriate antimicrobial therapy in HAP: What does this mean? Jaehee Lee, M.D. Kyungpook National University Hospital, Korea KNUH since 1907 Presentation outline Empiric antimicrobial choice: right spectrum,
More informationGeneral Approach to Infectious Diseases
General Approach to Infectious Diseases 2 The pharmacotherapy of infectious diseases is unique. To treat most diseases with drugs, we give drugs that have some desired pharmacologic action at some receptor
More informationLack of Change in Susceptibility of Pseudomonas aeruginosa in a Pediatric Hospital Despite Marked Changes in Antibiotic Utilization
Infect Dis Ther (2014) 3:55 59 DOI 10.1007/s40121-014-0028-8 BRIEF REPORT Lack of Change in Susceptibility of Pseudomonas aeruginosa in a Pediatric Hospital Despite Marked Changes in Antibiotic Utilization
More informationNosocomial Bloodstream Infections: Organisms, Risk Factors, and Implications
S139 Nosocomial Bloodstream Infections: Organisms, Risk Factors, and Implications Adolf W. Karchmer Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston,
More informationManagement of Skin and Soft-Tissue Infection
Clinical Decisions Interactive at www.nejm.org Management of Skin and Soft-Tissue Infection This interactive feature addresses the diagnosis or management of a clinical case. A case vignette is followed
More informationCarbapenemase-Producing Enterobacteriaceae (CPE)
Carbapenemase-Producing Enterobacteriaceae (CPE) September 21, 2017 Maryam Khan Peel Public Health Madeleine Ashcroft Public Health Ontario Objectives Differentiate the acronyms related to CPE (CPE,CPO,CRE,CRO)
More informationRISK FACTORS FOR PENICILLIN-RESISTANT STREPTOCOCCUS PNEUMONIAE ACQUISITION IN PATIENTS IN BANGKOK
RISK FACTORS FOR PENICILLIN-RESISTANT STREPTOCOCCUS PNEUMONIAE ACQUISITION IN PATIENTS IN BANGKOK Charungthai Dejthevaporn 1,2, Asda Vibhagool 1, Ammarin Thakkinstian 2, Sayomporn Sirinavin 2,3 and Malai
More informationEach copy of any part of a JSTOR transmission must contain the same copyright notice that appears on the screen or printed page of such transmission.
Nosocomial and Community-Acquired Staphylococcus aureus Bacteremias from 1980 to 1993: Impact of Intravascular Devices and Methicillin Resistance Author(s): James P. Steinberg, Catherine C. Clark, Betsy
More informationOther Enterobacteriaceae
GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER NUMBER 50: Other Enterobacteriaceae Author Kalisvar Marimuthu, MD Chapter Editor Michelle Doll, MD, MPH Topic Outline Topic outline - Key Issues Known
More informationStreptococcus pneumoniae Bacteremia: Duration of Previous Antibiotic Use and Association with Penicillin Resistance
MAJOR ARTICLE Streptococcus pneumoniae Bacteremia: Duration of Previous Antibiotic Use and Association with Penicillin Resistance Jörg J. Ruhe and Rodrigo Hasbun Department of Medicine, Infectious Diseases
More informationMETHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS IN U.S. HOSPITALS,
METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS IN U.S. HOSPITALS, 1975-1991 Adelisa L. Panlilio, MD, MPH; David H. Culver, PhD; Robert P. Gaynes, MD; Shailen Banerjee, PhD; Tonya S. Henderson, BS; James S.
More information