Staphylococcus aureus bacteraemia in Gauteng academic hospitals, South Africa

Show simple item record Fortuin-de Smidt, Melony C. Singh-Moodley1, Ashika Badat, Rubeina Quan, Vanessa Kularatne, Ranmini Nana, Trusha Lekalakala, M. Ruth Govender, N.P. (Nelesh) Perovic, Olga 2015-08-20T07:43:45Z 2015-08-20T07:43:45Z 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 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.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 ( 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

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