Methicillin-resistant Staphylococcus aureus bacteraemia in Western Australian teaching hospitals, 1997–1999: risk factors, outcomes and implications for management

S.P Cordova; C.H Heath; D.B McGechie; A.D Keil; M.Y Beers; T.V. Riley

doi:10.1016/j.jhin.2003.10.009

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Methicillin-resistant Staphylococcus aureus bacteraemia in Western Australian teaching hospitals, 1997–1999: risk factors, outcomes and implications for management

Journal article

Peer reviewed

Methicillin-resistant Staphylococcus aureus bacteraemia in Western Australian teaching hospitals, 1997–1999: risk factors, outcomes and implications for management

S.P Cordova, C.H Heath, D.B McGechie, A.D Keil, M.Y Beers and T.V. Riley

Journal of Hospital Infection, Vol.56(1), pp.22-28

2004

DOI: https://doi.org/10.1016/j.jhin.2003.10.009

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Abstract

The aim of this study was to document the evolution of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia at teaching hospitals in Perth, Western Australia (WA), and determine the risk factors and outcomes of the disease. We performed a retrospective case series analysis of all laboratory-confirmed episodes of S. aureus bacteraemia at Perth teaching hospitals between 1 July 1997 and 30 June 1999 by linking laboratory data with hospitalization data from the state's Hospital Morbidity Data System. Episodes of S. aureus bacteraemia were stratified according to methicillin susceptibility and the relationship between methicillin resistance and key factors or outcomes was determined. Almost 11% of episodes of S. aureus bacteraemia (55/509) were caused by MRSA. On age-adjusted multivariate analysis, Aboriginality (RR 6.71, 95% CI 3.20-14.10, P<0.001), geriatric unit admission (RR 5.74, 95% CI 2.01-16.37, P=0.001), female sex (RR 1.88, 95% CI 1.03-3.42, P=0.04) and healthcare-associated disease (RR 1.93, 95% CI 1.01-3.70, P=0.05) were independently associated with MRSA bacteraemia. Outcomes among those with MRSA bacteraemia included death in 15 patients and re-admission for an MRSA-related complication in five. Empirical use of vancomycin needs consideration in at-risk patients in whom Gram-positive bacteraemia is suspected clinically, with prompt review of therapy once antibiotic susceptibility results are known. The rates of re-admission after discharge for MRSA bacteraemia could be used as a clinical indicator to monitor the quality of care in hospitals

Details

Title: Methicillin-resistant Staphylococcus aureus bacteraemia in Western Australian teaching hospitals, 1997–1999: risk factors, outcomes and implications for management
Authors/Creators: S.P Cordova (Author/Creator) - Australian National University
C.H Heath (Author/Creator) - Royal Perth Hospital
D.B McGechie (Author/Creator) - Fremantle Hospital
A.D Keil (Author/Creator) - Princess Margaret Hospital for Children
M.Y Beers (Author/Creator) - Australian National University
T.V. Riley (Author/Creator) - Division of Microbiology and Infectious Diseases, Western Australian Centre for Pathology and Medical Research, Nedlands, WA 6009, Australia
Publication Details: Journal of Hospital Infection, Vol.56(1), pp.22-28
Publisher: Elsevier Ltd
Identifiers: 991005541391007891
Copyright: © 2003 The Hospital Infection Society
Murdoch Affiliation: Murdoch University
Language: English
Resource Type: Journal article

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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; Public, Environmental & Occupational Health
ESI research areas: Immunology