Table 1.
Annual changes in clinical and microbiological characteristics of 292 patients with sequence type 72 MRSA bacteremia.
| Characteristic | Number of patients (%) | Annual change | |
|---|---|---|---|
| RR (95% CI) | p value | ||
| Age (year), median (IQR) | 64 (53–72) | NA | NA |
| Male | 175 (59.9) | NA | NA |
| Place of acquisition | |||
| Community-onset | 147 (50.3) | 1.02 (0.97–1.08) | 0.47 |
| Community-acquired | 30 (10.3) | 0.96 (0.85–1.08) | 0.47 |
| Healthcare-associated | 117 (40.1) | 1.04 (0.98–1.10) | 0.24 |
| Hospital-acquired | 145 (49.7) | 0.98 (0.93–1.03) | 0.47 |
| Underlying disease | |||
| Diabetes mellitus | 108 (37.0) | 1.00 (0.94–1.07) | 0.94 |
| Solid tumor | 107 (36.6) | 1.01 (0.95–1.08) | 0.76 |
| Liver cirrhosis | 42 (14.4) | 1.08 (0.98–1.20) | 0.14 |
| End state renal disease | 41 (14.0) | 1.01 (0.91–1.12) | 0.86 |
| Charlson comorbidity index, median (IQR) | 2 (2–4.8) | 0.05* | 0.30 |
| APACHE II, median (IQR) | 16 (11–20) | − 0.03* | 0.83 |
| Pitt bacteremia score, median (IQR) | 1 (0–2) | − 0.01* | 0.82 |
| Septic shock | 33 (11.3) | 0.96 (0.86–1.07) | 0.45 |
| Central venous catheter | 88 (30.1) | 1.00 (0.93–1.07) | 0.93 |
| Prosthetic devicea | 58 (19.9) | 0.99 (0.91–1.07) | 0.75 |
| Characteristics of infection | |||
| CVC-related infection | 58 (19.9) | 0.94 (0.86–1.03) | 0.16 |
| Primary bacteremia | 42 (14.4) | 0.98 (0.89–1.09) | 0.72 |
| Bone and joint infection | 33 (11.3) | 0.96 (0.86–1.08) | 0.48 |
| Skin and soft tissue | 26 (8.9) | 1.08 (0.95–1.23) | 0.26 |
| Pneumonia | 24 (8.2) | 1.17 (1.02–1.35) | 0.03 |
| Infective endocarditis | 14 (4.8) | 1.01 (0.85–1.20) | 0.91 |
| Metastatic infection | 57 (19.5) | 0.89 (0.82–0.97) | 0.01 |
| Persistent bacteremia (≥ 3 d) | 116 (39.7) | 0.94 (0.89–1.00) | 0.045 |
| Recurrent bacteremia within 12 weeks | 13 (4.5) | 0.70 (0.56–0.89) | < 0.01 |
| 30-d mortality | 34 (11.6) | 1.08 (0.97–1.21) | 0.17 |
| 12-week mortality | 65 (22.3) | 1.02 (0.94–1.11) | 0.60 |
| Infection-attributable mortality | 38 (13.0) | 1.08 (0.97–1.20) | 0.17 |
| In-hospital crude mortality | 39 (13.4) | 1.05 (0.95–1.17) | 0.34 |
| Vancomycin MIC (BMD), mean ± SD (mg/L) | 1.08 ± 0.20 | − 0.01*b | 0.01 |
| agr dysfunction | 31 (10.6) | 1.02 (0.90–1.14) | 0.79 |
| SCCmec type | |||
| SCCmec IV | 291 (99.7) | 1.00 (0.96–1.04) | 0.96 |
| SCCmec IVa | 251/291 (86.3) | 0.99 (0.95–1.03) | 0.64 |
| spa type | |||
| t324 | 139 (47.6) | 0.96 (0.91–1.02) | 0.19 |
| t664 | 42 (14.4) | 0.96 (0.87–1.06) | 0.39 |
| t148 | 33 (11.3) | 0.98 (0.88–1.10) | 0.72 |
| Others | 49 (16.8) | NA | NA |
| Antibiotic resistance | |||
| Amoxicillin/Clavulanate | 271 (92.8) | 1.00 (0.97–1.04) | 0.85 |
| Clindamycin | 58 (19.9) | 0.98 (0.90–1.07) | 0.68 |
| Ciprofloxacin | 23 (7.9) | 1.15 (1.00–1.33) | 0.05 |
| Erythromycin | 75 (25.7) | 0.89 (0.82–0.96) | < 0.01 |
| Fusidic acid | 3 (1.0) | 1.11 (0.75–1.63) | 0.60 |
| Gentamicin | 39 (13.4) | 0.95 (0.86–1.06) | 0.35 |
| Rifampin | 5 (1.7) | 1.12 (0.83–1.51) | 0.47 |
| Quinupristin/Dalfopristin | 0 | NA | NA |
| TMP/SMX | 2 (0.7) | 0.85 (0.53–1.39) | 0.52 |
| Tetracycline | 8 (2.7) | 1.07 (0.85–1.35) | 0.58 |
IQR interquartile range; APACHE II acute physiology and chronic health evaluation II; CVC central venous catheter; MIC minimum inhibitory concentration; BMD broth microdilution method; SCC staphylococcal cassette chromosome; TMP/SMX trimethoprim/sulfamethoxazole.
*A linear regression model was used for analysis.
aProsthetic device included orthopedic devices (14 patients), cardiovascular implantable electronic devices (4 patients), prosthetic valves (11 patients), and vascular grafts (30 patients) in patients with persistent bacteremia.
bResult of linear regression: R2 = 0.025, vancomycin MIC = 22.07 + (− 0.01) × year.