dc.date.accessioned | 2018-03-22T23:38:48Z | |
dc.date.available | 2018-03-22T23:38:48Z | |
dc.date.created | 2018-03-22T23:38:48Z | |
dc.date.issued | 2017 | |
dc.identifier | https://hdl.handle.net/20.500.12866/1470 | |
dc.identifier | https://doi.org/10.1093/jac/dkx350 | |
dc.description.abstract | Background: Substantial heterogeneity in the epidemiology and management of Staphylococcus aureus bacteraemia (SAB) occurs in Latin America. We conducted a prospective cohort study in 24 hospitals from nine Latin American countries. Objectives: To assess the clinical impact of SAB in Latin America. Patients and methods: We evaluated differences in the 30 day attributable mortality among patients with SAB due to MRSA compared with MSSA involving 84 days of follow-up. Adjusted relative risks were calculated using a generalized linear model. Results: A total of 1030 patients were included. MRSA accounted for 44.7% of cases with a heterogeneous geographical distribution. MRSA infection was associated with higher 30 day attributable mortality [25% (78 of 312) versus 13.2% (48 of 363), adjusted RR: 1.94, 95% CI: 1.38–2.73, P < 0.001] compared with MSSA in the multivariable analysis based on investigators’ assessment, but not in a per-protocol analysis [13% (35 of 270) versus 8.1% (28 of 347), adjusted RR: 1.10, 95% CI: 0.75–1.60, P = 0.616] or in a sensitivity analysis using 30 day all-cause mortality [36% (132 of 367) versus 27.8% (123 of 442), adjusted RR: 1.09, 95% CI: 0.96–1.23, P = 0.179]. MRSA infection was not associated with increased length of hospital stay. Only 49% of MSSA bloodstream infections (BSI) received treatment with β-lactams, but appropriate definitive treatment was not associated with lower mortality (adjusted RR: 0.93, 95% CI: 0.70–1.23, P = 0.602). Conclusions: MRSA-BSIs in Latin America are not associated with higher 30 day mortality or longer length of stay compared with MSSA. Management of MSSA-BSIs was not optimal, but appropriate definitive therapy did not appear to influence mortality. | |
dc.language | eng | |
dc.publisher | Oxford University Press | |
dc.relation | Journal of Antimicrobial Chemotherapy | |
dc.relation | 1460-2091 | |
dc.rights | https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es | |
dc.rights | info:eu-repo/semantics/restrictedAccess | |
dc.subject | staphylococcus aureus | |
dc.subject | bacteremia | |
dc.subject | epidemiology | |
dc.subject | heterogeneity | |
dc.subject | follow-up | |
dc.subject | lactams | |
dc.subject | latin america | |
dc.subject | length of stay | |
dc.subject | prospective studies | |
dc.subject | mortality | |
dc.subject | methicillin-resistant staphylococcus aureus | |
dc.subject | bloodstream infections | |
dc.subject | methicillin-susceptible staphylococcus aureus | |
dc.subject | per protocol analysis | |
dc.subject | sensitivity analysis | |
dc.subject | methicillin-resistant staphylococcus aureus infection | |
dc.title | Staphylococcus aureus bloodstream infections in Latin America: results of a multinational prospective cohort study | |
dc.type | info:eu-repo/semantics/article | |