Por favor, use este identificador para citar o enlazar este Item:http://hdl.handle.net/20.500.12105/20155
Título
Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patients
Autor(es)
Cuervo, Guillermo | Camoez, Mariana | Shaw, Evelyn | Angeles Dominguez, Maria | Gasch, Oriol | Padilla, Belen | Pintado, Vicente | Almirante, Benito | Molina, Jose | Lopez-Medrano, Francisco | Ruiz de Gopegui-Bordes, Enrique | Martinez, Jose A | Bereciartua, Elena | Rodriguez-Lopez, Fernando | Fernandez-Mazarrasa, Carlos | Angel Goenaga, Miguel | Benito, Natividad | Rodriguez-Bano, Jesus | Espejo, Elena | Pujol, Miquel | REIPI GEIH Study Grp
Fecha de publicación
2015-10-30
Cita
Cuervo G, Camoez M, Shaw E, Dominguez MA, Gasch O, Padilla B, et al. Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patients. BMC Infect Dis. 2015 Oct 30;15:484.
Idioma
Inglés
Tipo de documento
research article
Resumen
Background: The aim of the study was to determine clinical and microbiological differences between patients with methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia (CRB) undergoing or not undergoing haemodialysis, and to compare outcomes. Methods: Prospective multicentre study conducted at 21 Spanish hospitals of patients with MRSA bacteraemia diagnosed between June 2008 and December 2009. Patients with MRSA-CRB were selected. Data of patients on haemodialysis (HD-CRB) and those not on haemodialysis (non-HD-CRB) were compared. Results: Among 579 episodes of MRSA bacteraemia, 218 (37.7 %) were CRB. Thirty-four (15.6 %) were HD-CRB and 184 (84.4 %) non-HD-CRB. All HD-CRB patients acquired the infection at dialysis centres, while in 85.3 % of the non-HD-CRB group the infection was nosocomial (p < .001). There were no differences in age, gender or severity of bacteraemia (Pitt score); comorbidities (Charlson score >= 4) were higher in the HD-CRB group than in the non-HD-CRB group (73.5 % vs. 46.2 %, p = .003). Although there were no differences in VAN-MIC >= 1.5 mg/L according to microdilution, using the E-test a higher rate of VAN-MIC >= 1.5 mg/L was observed in HD-CRB than in non-HD-CRB patients (63.3 % vs. 44.1 %, p = .051). Vancomycin was more frequently administered in the HD-CRB group than in the non-HD-CRB group (82.3 % vs. 42.4 %, p = <. 001) and therefore the appropriate empirical therapy was significantly higher in HD-CRB group (91.2 % vs. 73.9 %, p = .029). There were no differences with regard to catheter removal (79.4 % vs. 84.2 %, p = .555, respectively). No significant differences in mortality rate were observed between both groups (Overall mortality: 11.8 % vs. 27.2 %, p = .081, respectively), but there was a trend towards a higher recurrence rate in HD-CRB group (8.8 % vs. 2.2 %, p = .076). Conclusions: In our multicentre study, ambulatory patients in chronic haemodialysis represented a significant proportion of cases of MRSA catheter-related bacteraemia. Although haemodialysis patients with MRSA catheter-related bacteraemia had significantly more comorbidities and higher proportion of strains with reduced vancomycin susceptibility than non-haemodialysis patients, overall mortality between both groups was similar.
Palabras clave
MESH
Bacteremia | Aged | Spain | Anti-Bacterial Agents | Cross Infection | Humans | Renal Dialysis | Middle Aged | Male | Prospective Studies | Female | Methicillin-Resistant Staphylococcus aureus | Treatment Outcome | Vancomycin | Catheter-Related Infections | Comorbidity | Staphylococcal Infections
DECS
Resultado del Tratamiento | Vancomicina | Comorbilidad | Infecciones Estafilocócicas | Femenino | Masculino | Diálisis Renal | Staphylococcus aureus Resistente a Meticilina | Humanos | Persona de Mediana Edad | Estudios Prospectivos | Anciano | Infección Hospitalaria | Bacteriemia | Antibacterianos | Infecciones Relacionadas con Catéteres | España
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