Journal article
Clinical and laboratory features of invasive community-onset methicillin-resistant Staphylococcus aureus infection: a prospective case–control study
European Journal of Clinical Microbiology & Infectious Diseases, Vol.29(8), pp.1025-1033
2010
Abstract
Differences between the features of invasive community-onset methicillin-resistant Staphylococcus aureus (cMRSA) and methicillin-susceptible S. aureus (cMSSA) infections are incompletely understood. Fifty-seven patients with invasive cMRSA infection were prospectively identified at two teaching hospitals; for each cMRSA case, two cases of invasive cMSSA infection acted as controls. The primary outcome was 30-day all-cause mortality. Patients with invasive cMRSA infection were more likely to be Aboriginal (25% vs. 14%, age-adjusted odds ratio [OR] 2.5, p=0.037), reside in a long-term care facility and/or have been hospitalised in the previous year (51% vs. 34%, p=0.04) and less likely to have endocarditis (2% vs. 12%, p=0.02) or require admission to an intensive care unit or high-dependency area (7% vs. 21%, p=0.02). All-cause mortality at 30 days was similar in the cMRSA and cMSSA groups (9% vs. 7%, p=0.68). Panton-Valentine leukocidin (PVL) genes were detected in a similar proportion of cMRSA and cMSSA isolates (32% vs. 27%, p=0.49) and the presence of PVL genes was associated with younger age (35 years vs. 55 years, p<0.001), Aboriginal ethnicity (38% vs. 10%, p<0.001), skin and soft-tissue infection (54% vs. 19%, p<0.001), lower illness severity at presentation (SAPS II score 9 vs. 21, p=0.001) and shorter hospitalisation (9 days vs. 24 days, p<0.001). Patients with "PVL-positive" and "PVL-negative" S. aureus infection had similar 30-day all-cause mortality (4% vs. 9%, p=0.28). Few clinical features differentiated patients with invasive cMRSA infection from those with infection caused by cMSSA. Invasive "PVL-positive" S. aureus infection was associated with less morbidity but similar mortality to "PVL-negative" infection.
Details
- Title
- Clinical and laboratory features of invasive community-onset methicillin-resistant Staphylococcus aureus infection: a prospective case–control study
- Authors/Creators
- M.C. Wehrhahn (Author/Creator) - Royal Perth HospitalJ.O. Robinson (Author/Creator) - Curtin UniversityJ.C. Pearson (Author/Creator) - Curtin UniversityF.G. O’Brien (Author/Creator)H.L. Tan (Author/Creator) - Curtin UniversityG.W. Coombs (Author/Creator) - Curtin UniversityE.M. Pascoe (Author/Creator) - Princess Margaret Hospital for ChildrenR. Lee (Author/Creator) - Royal Perth HospitalP. Salvaris (Author/Creator) - The University of Western AustraliaR. Salvaris (Author/Creator) - The University of Western AustraliaD. New (Author/Creator) - The University of Western AustraliaR.J. Murray (Author/Creator) - Royal Perth Hospital
- Publication Details
- European Journal of Clinical Microbiology & Infectious Diseases, Vol.29(8), pp.1025-1033
- Publisher
- Springer Verlag
- Identifiers
- 991005541355707891
- Copyright
- © 2010 Springer-Verlag.
- Murdoch Affiliation
- Murdoch University
- Language
- English
- Resource Type
- Journal article
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Source: InCites
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- Collaboration types
- Domestic collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.23 Antibiotics & Antimicrobials
- 1.23.173 MRSA and VRE
- Web Of Science research areas
- Infectious Diseases
- Microbiology
- ESI research areas
- Microbiology