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Volume 37, Number 1, February 2004

Epidemiology of community-acquired Staphylococcus aureus bacteremia


Chih-Yu Chi, Wing-Wai Wong, Chang-Phone Fung, Kwok-Woon Yu, Cheng-Yi Liu
Section of Infectious Diseases, Departments of Medicine and Pathology and Laboratory Medicine, Taipei Veterans General Hospital, and National Yang-Ming University, Taipei, Taiwan, ROC

Received: February 21, 2003    Revised: June 26, 2003    Accepted: July 8, 2003   

 

Corresponding author:

Dr. Wing-Wai Wong, Section of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, 201, Shih-Pai Road, Section 2, Taipei, Taiwan 11217, ROC. E-mail: wwwong@vghtpe.gov.tw This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

 



 

Methods:

Methicillin-resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen which has been isolated with increasing frequency in recent decades. Community-acquired MRSA (CA-MRSA) infections have also become increasingly important in recent years. This study retrospectively analyzed the risk factors, duration of hospitalization, yearly trend and seasonal variation in prevalence, and antibiotic susceptibility of isolates of community-acquired S. aureus (CASA) bacteremia and CA-MRSA bacteremia from patients treated in a teaching hospital in northern Taiwan. A total of 104 clinical isolates of CASA bacteremia were collected between January 1999 and December 2001. Among these, 35 (33.7%) were identified as MRSA. After multivariate analysis, the independent risk factors for developing CA-MRSA bacteremia were diabetes mellitus (p=0.028), chronic obstructive lung disease (p=0.037), and renal insufficiency (p=0.041). Only 6 (17.1%) patients in the MRSA group had no identified risk factors. Most of the isolates of CA-MRSA had a high degree of resistance to most antibiotics, including clindamycin (71.4%), trimethoprim-sulfamethoxazole (65.7%), and chloramphenicol (41.2%). No major trend or seasonal variation in the prevalence was found during the study period. No difference in mortality related to resistance pattern was found. Although CA-MRSA is not the major pathogen in community-acquired bacteremia, it should be included in the differential diagnosis of Gram-positive bacterial bloodstream infection, especially in those patients with risk factors. Early empiric therapy with glycopeptides in these patients may reduce morbidity and mortality.

 



 

Key words:

Bacteremia, community-acquired infections, methicillin resistance, Staphylococcus aureus



 



 

J Microbiol Immunol Infect 2004;37:16-23.