Table 1.
Demographic and clinical characteristics of 345 patients with healthcare-associated methicillin-resistant Staphylococcus aureus bacteremia according to the appropriateness of initial empirical antimicrobial therapy
| Variables | All (n = 345) | Appropriate (n = 154, 44.6 %) | Inappropriate (n = 191, 55.4 %) | Odds ratio (95 % confidence interval) |
|---|---|---|---|---|
| Male sex | 154 (44.6) | 97 (43.9) | 124 (56.1) | 0.92 (0.59–1.43) |
| Age (years), median (IQR) | 67 (52–75) | 66 (51–74) | 67 (53–75) | 0.99 (0.98–1.01) |
| Category of infection | ||||
| Healthcare-associateda | 51 (14.8) | 29 (18.8) | 22 (11.5) | 1.78 (0.98–3.25) |
| Nosocomial | 294 (85.2) | 125 (81.2) | 169 (88.5) | |
| Comorbidity | ||||
| Malignancy | 97 (28.1) | 47 (30.5) | 50 (26.2) | 0.81 (0.50–1.29) |
| Metabolic | 122 (35.4) | 52 (33.8) | 70 (36.6) | 1.14 (0.73–1.77) |
| Trauma | 29 (8.4) | 10 (6.5) | 19 (9.9) | 1.59 (0.72–3.53) |
| Charlson’s comorbidity indexb, median (IQR) | 2 (1–4) | 2 (1–5) | 2 (1–4) | 1.09 (1.00–1.20) |
| Primary focus of HA-MRSAB | ||||
| CR-BSI | 177 (51.3) | 93 (60.4) | 84 (44.0) | 0.52 (0.34–0.79) |
| Pneumonia | 40 (11.6) | 13 (8.4) | 27 (14.1) | 1.79 (0.89–3.59) |
| Clinical severity | ||||
| Development of severe sepsis or septic shock | 99 (28.7) | 50 (32.5) | 49 (25.7) | 0.72 (0.45–1.15) |
| Pitt’s bacteremia score at onset of bacteremiac, median (IQR) | 1 (0–2) | 1 (0–3) | 1 (0–2) | 1.08 (0.96–1.21) |
| Predisposing factors | ||||
| Surgical operation | 84 (24.3) | 29 (18.8) | 55 (28.8) | 1.74 (1.05–2.91) |
| Foreign body retention | 15 (4.3) | 12 (7.8) | 3 (1.6) | 0.189 (0.05–0.69) |
| Prior antibiotics use | 219 (63.5) | 99 (64.3) | 120 (62.8) | 0.94 (0.60–1.46) |
| Vancomycin MIC, mg/L | 1 (1–1.5) | 1 (1–1.5) | 1 (1–1.5) | 1.57 (0.81–3.04) |
| Outcomes | ||||
| In-hospital mortality | 114 (33.0) | 51 (33.1) | 63 (33.0) | 0.99 (0.63–1.56) |
| MRSAB-related mortality | 57 (16.5) | 24 (15.6) | 33 (17.3) | 1.13 (0.64–2.01) |
IQR interquartile range, APACHE acute physiology and chronic health evaluation, CR-BSI catheter-related bloodstream infection, MIC minimum inhibitory concentration, MRSAB methicillin-resistant Staphylococcus aureus bacteremia
aMRSAB diagnosed within 48 h of hospital admission was considered healthcare-associated infection, if the patient presented with any healthcare-associated factor in the preceding 3 months
bCharlson’s comorbidity score was calculated at the onset of MRSA bacteremia infection
cPitt’s bacteremia score and APACHE II scores were assessed at the onset of MRSA bacteremia