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Influence of antimicrobial regimen on decreased in-hospital mortality of patients with MRSA bacteremia


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Title: Influence of antimicrobial regimen on decreased in-hospital mortality of patients with MRSA bacteremia
Authors: Kaku, Norihito / Yanagihara, Katsunori / Morinaga, Yoshitomo / Yamada, Koichi / Harada, Yosuke / Migiyama, Yohei / Nagaoka, Kentaro / Matsuda, Jun-ichi / Uno, Naoki / Hasegawa, Hiroo / Miyazaki, Taiga / Izumikawa, Koichi / Kakeya, Hiroshi / Yamamoto, Yoshihiro / Kohno, Shigeru
Issue Date: Jun-2014
Publisher: 日本化学療法学会・日本感染症学会 / Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases
Citation: Journal of Infection and Chemotherapy, 20(6), pp.350-355; 2014
Abstract: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most important causes of bacteremia. Recently, several epidemiological and microbiological changes have become evident in MRSA infections. The purposes of this study were to assess clinical characteristics of patients with MRSA bacteremia and microbiological changes in MRSA. We conducted a retrospective observational study on patients with MRSA bacteremia who were hospitalized between 2008 and 2011. We used univariate and multivariate analysis to evaluate the predictors associated with 30-day mortality. The 7-day and 30-day mortality rates were 12.0% and 25.3%, respectively. According to multivariate analysis, the independent predictors that associated with 30-day mortality were leukopenia, low serum albumin, high sequential organ failure assessment (SOFA) score, and quinolone use within 30 days. Compared to previous data (2003-2007), the SOFA score of the new data set remained unchanged, but in-hospital mortality decreased significantly. In particular, the mortality associated with use of vancomycin (VCM) was significantly lower. Although the minimuminhibitory concentration of VCM required to inhibit the growth of 90% of organisms (MIC90) had not changed, the trough value of VCM changed significantly; a VCM trough value of 10 or greater was significantly higher compared to previous data. Of the staphylococcal cassette chromosome mec (SCCmec) types, SCCmec II values decreased significantly, and SCCmec I and IV values increased significantly. Our results indicate that changes in VCM usage might contribute to decreased in-hospital mortality.
Keywords: Bacteremia / Methicillin-resistant Staphylococcus aureus / MIC / Mortality / SCCmec
URI: http://hdl.handle.net/10069/34970
ISSN: 1341321X
DOI: 10.1016/j.jiac.2013.12.009
Rights: © 2014, Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. / NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Infection and Chemotherapy. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Infection and Chemotherapy, 20, 6, (2014)
Type: Journal Article
Text Version: author
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/34970

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