RT Journal Article
T1 Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patients.
A1 Cuervo, Guillermo
A1 Camoez, Mariana
A1 Shaw, Evelyn
A1 Dominguez, María Ángeles
A1 Gasch, Oriol
A1 Padilla, Belén
A1 Pintado, Vicente
A1 Almirante, Benito
A1 Molina, José
A1 López-Medrano, Francisco
A1 Ruiz de Gopegui, Enrique
A1 Martinez, José A
A1 Bereciartua, Elena
A1 Rodriguez-Lopez, Fernando
A1 Fernandez-Mazarrasa, Carlos
A1 Goenaga, Miguel Ángel
A1 Benito, Natividad
A1 Rodriguez-Baño, Jesús
A1 Espejo, Elena
A1 Pujol, Miquel
K1 Bacteraemia
K1 Catheter-related
K1 Haemodialysis
K1 MRSA
K1 Meticilina
K1 Staphylococcus aureus resistente a meticilina
K1 Estudios prospectivos
K1 Infecciones estafilocócicas
K1 Comorbilidad
K1 Infección hospitalaria
K1 Vancomicina
AB BACKGROUNDThe 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.METHODSProspective 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.RESULTSAmong 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).CONCLUSIONSIn 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.
PB BioMed Central
YR 2015
FD 2015-10-30
LK http://hdl.handle.net/10668/2355
UL http://hdl.handle.net/10668/2355
LA en
NO Cuervo G, Camoez M, Shaw E, Dominguez MÁ, Gasch O, Padilla B, et al. Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patients. BMC Infect. Dis. 2015, vol.15:484
NO Journal Article; Research Support, Non-U.S. Gov't;
DS RISalud
RD Apr 17, 2025