J Korean Med Sci.  2007 Aug;22(4):682-686. 10.3346/jkms.2007.22.4.682.

Analysis of Methicillin Resistance among Staphylococcus aureus Blood Isolates in an Emergency Department

• Heo ST
• Peck KR
• Ryu SY
• Kwon KT
• Ko KS
• Oh WS
• Lee NY
• Song JH

• KMID: 1127087
• DOI: http://doi.org/10.3346/jkms.2007.22.4.682

Abstract

The increasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) has become of great concern in both hospital and community settings. To evaluate the prevalence and risk factors for methicillin resistance among Staphylococcus aureus, blood isolates in our Emergency Department (ED) were collected. All patients with S. aureus bacteremia (SAB) who presented to the ED from January 2000 to August 2005 were included, and a retrospective study was performed. A total of 231 patients with SAB were enrolled (median age, 59 yr; M:F, 125:106). Among these patients, methicillin-resistant strains accounted for 27.3% (63 patients). Catheter-related infection was the most frequent primary site of SAB (39.0%), followed by skin and soft tissue infection (16.5%). In multivariate analysis, recent surgery (OR, 3.41; 95% CI, 1.48-7.85), recent hospitalization (2.17; 1.06-4.62), and older age (> or =61 yr) (2.39; 1.25-4.57) were independently associated with the acquisition of methicillin-resistant strains. When antimicrobial therapy is considered for the treatment of a patient with suspected SAB, clinicians should consider obtaining cultures and modifying empirical therapy to provide MRSA coverage for patients with risk factors: older age, recent hospitalization, and recent surgery.

Keyword

Staphylococcus aureus; Community-acquired Infections; Methicillin Resistance; Risk Factors

MeSH Terms

Adult
Age Factors
Aged
Anti-Bacterial Agents/pharmacology/therapeutic use
Cross Infection/blood/drug therapy/microbiology
Emergency Service, Hospital/statistics & numerical data
Female
Humans
Male
Methicillin/pharmacology/*therapeutic use
*Methicillin Resistance
Middle Aged
Multivariate Analysis
Retrospective Studies
Risk Factors
Staphylococcal Infections/blood/drug therapy/*microbiology
Staphylococcus aureus/*drug effects/isolation & purification

Figure

• 

  Fig. 1 The proportion of MRSA among S. aureus isolates recovered from the blood within 72 hr of ED visit for the study years. The dashed line is a trend bar of proportions. MRSA, methicillin-resistant S. aureus.

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