dc.contributor.author |
Fortuin-de Smidt, Melony C.
|
|
dc.contributor.author |
Singh-Moodley1, Ashika
|
|
dc.contributor.author |
Badat, Rubeina
|
|
dc.contributor.author |
Quan, Vanessa
|
|
dc.contributor.author |
Kularatne, Ranmini
|
|
dc.contributor.author |
Nana, Trusha
|
|
dc.contributor.author |
Lekalakala, M. Ruth
|
|
dc.contributor.author |
Govender, N.P. (Nelesh)
|
|
dc.contributor.author |
Perovic, Olga
|
|
dc.date.accessioned |
2015-08-20T07:43:45Z |
|
dc.date.available |
2015-08-20T07:43:45Z |
|
dc.date.issued |
2015-01 |
|
dc.description.abstract |
INTRODUCTION : Methicillin-resistant Staphylococcus aureus (MRSA) infections are responsible for longer
hospital stays, increased hospital costs, and poorer outcomes compared to methicillin-sensitive S. aureus
(MSSA) infections. We aimed to describe the epidemiology of S. aureus bacteraemia (SAB) and to
determine factors associated with MRSA infection in South Africa.
METHODS : Cases of SAB were reported from September 2012 to September 2013 from three sentinel sites.
A case was defined as the isolation of S. aureus from a blood culture during a 21-day period. Detailed
clinical information was collected. Multivariable logistic regression was done to determine factors
associated with MRSA infection and mortality.
RESULTS : There were 442 cases of SAB reported; antimicrobial susceptibility testing was performed on
240 isolates (54%). Thirty-six percent (86/240) of cases had an MRSA infection. A longer hospital stay
before positive specimen collection (odds ratio (OR) 1.08, 95% confidence interval (CI) 1.02–1.13,
p = 0.004), hospitalization in the last year (OR 15.7, 95% CI 2.5–99.5, p = 0.003), HIV infection (OR 4.9, 95%
CI 1.05–22.90, p = 0.044), and antibiotic use in the previous 2 months (OR 0.1, 95% CI 0.01–0.68,
p = 0.022) were independent predictors of MRSA. Older age, and in particular age 25–44 years (OR 22.2,
95% CI 2.7–185.5, p = 0.004, compared to those aged < 5 years), was the only independent predictor of
mortality amongst cases with SAB. MRSA isolates were non-susceptible to more antimicrobial agents
compared to MSSA isolates.
CONCLUSIONS : HIV infection was an independent risk factor for MRSA infection. The selection of
appropriate empirical antimicrobial treatment is essential in patients with MRSA infections because of
non-susceptibility to many other antimicrobial classes. |
en_ZA |
dc.description.librarian |
hb2015 |
en_ZA |
dc.description.sponsorship |
National Institute for Communicable Diseases/National Health Laboratory Service NICD/NHLS), the Global Diseases Detection Program (GDD), and by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and
Prevention (CDC) under the terms of cooperative agreement 5U2GPS001328. |
en_ZA |
dc.description.uri |
http://www.elsevier.com/locate/ijid |
en_ZA |
dc.identifier.citation |
Fortuin-de Smidt, MC, Singh-Moodley, A, Badat, R, Quan, V, Kularatne, R, Nana, T, Lekalakala, MR., Govender, NP & Perovic, O 2015, 'Staphylococcus aureus bacteraemia in Gauteng academic hospitals, South Africa', International Journal of Infectious Diseases, vol. 30, pp. 41-48. |
en_ZA |
dc.identifier.issn |
1201-9712 (print) |
|
dc.identifier.issn |
1878-3511 (online) |
|
dc.identifier.other |
10.1016/j.ijid.2014.10.011 |
|
dc.identifier.uri |
http://hdl.handle.net/2263/49410 |
|
dc.language.iso |
en |
en_ZA |
dc.publisher |
Elsevier (open access) |
en_ZA |
dc.rights |
© 2014 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/). |
en_ZA |
dc.subject |
Staphylococcus aureus |
en_ZA |
dc.subject |
Bacteraemia |
en_ZA |
dc.subject |
Methicillin-resistant |
en_ZA |
dc.subject |
HIV infection |
en_ZA |
dc.subject |
Mortality |
en_ZA |
dc.subject |
Human immunodeficiency virus (HIV) |
en_ZA |
dc.title |
Staphylococcus aureus bacteraemia in Gauteng academic hospitals, South Africa |
en_ZA |
dc.type |
Article |
en_ZA |