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Community-associated methicillin-resistant Staphylococcus aureus: risk factors for infection, and long-term follow-up

Aramburu, C.
Pastore, R.
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Published in Clinical Microbiology and Infection. 2009, vol. 15, no. 6, p. 552-559
Abstract Uncertainty persists about risk factors for community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections in Europe and the long-term efficacy of decolonization strategies. To evaluate risk factors for CA-MRSA in Geneva, Switzerland, a hospital-based, retrospective case-control study of 26 patients with CA-MRSA infection and 60 control patients was performed. To evaluate the long-term effect of a systematic decolonization strategy (with and without concomitant systemic antibiotic therapy) for CA-MRSA patients, a prospective cohort study of 79 patients with Panton-Valentine leukocidin-producing CA-MRSA isolates was conducted. Nationality other than European Union or Swiss (adjusted OR 6.09; 95% CI 1.07-34.65) and absence of healthcare contact (adjusted OR 0.11, 95% CI 0.02-0.59) were independent predictors of CA-MRSA infection. Forty-five cases were followed (median, 22 months) to assess the long-term efficacy of the decolonization strategy; 39/45 (86.7%) had no clinical relapse and were MRSA-negative at their last follow-up, whereas six remained MRSA-positive. Five of these six cases belonged to a family cluster. Decolonization rates were similar between infected patients and asymptomatic carriers (92.6% vs. 77.8%, p = 0.20). This study shows a lack of readily modifiable risk factors for CA-MRSA infection in this population, and suggests the potential usefulness of conducting decolonization procedures in a setting with sporadic CA-MRSA infection. Further studies are needed to elucidate the role of migration as a factor contributing to the emergence of CA-MRSA in Europe.
Keywords AdultCarrier State/drug therapy/epidemiology/microbiologyCase-Control StudiesCommunity-Acquired Infections/drug therapy/ epidemiology/ microbiologyFemaleFollow-Up StudiesHumansMaleMethicillin-Resistant Staphylococcus aureus/ isolation & purificationMiddle AgedRetrospective StudiesRisk FactorsStaphylococcal Infections/drug therapy/ epidemiology/ microbiologySwitzerland/epidemiologyYoung Adult
PMID: 19416294
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Research groups Groupe Harbarth Stephan (Staphylocoques dorés résistants à la méthicilline) (866)
Staphylocoques dorés résistants à la méthicilline et hygiène hospitalière (330)
Etiologie des pneumonies et marqueurs inflammatoires chez l'enfant fébrile (183)
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LONGTIN, Yves et al. Community-associated methicillin-resistant Staphylococcus aureus: risk factors for infection, and long-term follow-up. In: Clinical Microbiology and Infection, 2009, vol. 15, n° 6, p. 552-559. https://archive-ouverte.unige.ch/unige:7415

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Deposited on : 2010-06-21

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