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Healthcare‐Associated Staphylococcus aureus Bacteremia and the Risk for Methicillin Resistance: Is the Centers for Disease Control and Prevention Definition for Community‐Acquired Bacteremia Still Appropriate?
Formats Available in JSTOR: PDF
Abstract(back to top)
OBJECTIVE. To evaluate a new classification for bloodstream infections that differentiates hospital acquired, healthcare associated, and community acquired in patients with blood cultures positive for Staphylococcus aureus.
DESIGN. Prospective, observational study.
SETTING. Three tertiary‐care, university‐affiliated hospitals in Dublin, Ireland, and Strasbourg, France.
PATIENTS. Two hundred thirty consecutive patients older than 18 years with blood cultures positive for S. aureus.
METHODS. S. aureus bacteremia (SAB) was defined as hospital acquired if the first positive blood culture was performed more than 48 hours after admission. Other SABs were classified as healthcare associated or community acquired according to the definition proposed by Friedman et al. When available, strains of methicillin‐resistant Staphylococcus aureus (MRSA) were analyzed by pulsed‐field gel electrophoresis (PFGE).
RESULTS. Eighty‐two patients were considered as having community‐acquired bacteremia according to the Centers for Disease Control and Prevention (CDC) classification. Of these 82 patients, 56% (46) had healthcare‐associated SAB. MRSA prevalence was similar in patients with hospital‐acquired and healthcare‐associated SAB (41% vs 33%; P > .05), but significantly lower in the group with community‐acquired SAB (11%; P < .03). PFGE of MRSA strains showed that most community‐acquired and healthcare‐associated MRSA strains were similar to hospital‐acquired MRSA strains. On multivariate analysis, Friedman’s classification was more effective than the CDC classification for predicting MRSA.
CONCLUSION. These results support the call for a new classification for community‐acquired bacteremia that would account for healthcare received outside the hospital by patients with SAB.
Bibliographic Information(back to top)
- Healthcare‐Associated Staphylococcus aureus Bacteremia and the Risk for Methicillin Resistance: Is the Centers for Disease Control and Prevention Definition for Community‐Acquired Bacteremia Still Appropriate?
- Olivier Lesens , MD, Yves Hansmann , MD, Eimar Brannigan , MD, Susan Hopkins , MD, Pierre Meyer , PhD, Brian O’Connel , MD, Gilles Prévost , PhD, Colm Bergin , MD and Daniel Christmann , MD
- Infection Control and Hospital Epidemiology
- Vol. 26, No. 2 (February 2005) (pp. 204-209)
Notes and References(back to top)
This item contains 1 note(s).
Notes
Dr. Lesens is from the Service des Maladies Infectieuses et Tropicales, Hôtel‐Dieu, Clermont‐Ferrand, France. Drs. Hansmann and Christmann are from the Service des Maladies Infectieuses et Tropicales, Clinique Médicale A, Hôpitaux Universitaires; Dr. Meyer is from the Laboratoire de biostatistique, Faculté de Médecine; and Dr. Prévost is from the Service de bactériologie, Faculté de Médecine, Strasbourg, France. Drs. Brannigan, Hopkins, and Bergin are from the Genitourinary Medicine and Infectious Diseases Department; and Dr. Connel is from the Department of Microbiology, St. James Hospital, Dublin, Ireland.Address reprint requests to Olivier Lesens, MD, Service des Maladies Infectieuses et Tropicales, Hôtel‐Dieu, CHU, 63000 Clermont‐Ferrand, France. olivier.lesens@wanadoo.frSupported by Laboratoires Merck Sharp & Dohme‐Chibret, a grant from the French government (Bourse Lavoisier du Ministère des Affaires Etrangères), and a grant from the Association des Professeurs de Pathologie Infectieuse et Tropicale.The authors thank Henri Laurichesse, MD, for reviewing the manuscript.
Items Citing this Item (back to top)
4 item(s) in JSTOR cite this item
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