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C?reactive protein predicts persistent bacteremia caused by community?acquired methicillin?resistant Staphylococcus aureus strain

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Abstract
There is limited data on persistent bacteremia (PB) caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). Here, we aimed to investigate the clinical and microbiological characteristics of PB caused by the major CA-MRSA strain in Korea (ST72-SCCmecIV). All adult patients with S. aureus bacteremia were prospectively investigated from August 2008 to December 2018. Patients with ST72 MRSA bacteremia were included in the study. Patients were stratified into the PB group (defined as positive blood cultures for ≥ 3 days) and short bacteremia (SB) group. A total of 291 patients were included, comprising 115 (39.5%) with PB and 176 (60.5%) with SB. Although the 30-day mortality did not differ between PB and SB, recurrent bacteremia within 12 weeks was significantly more common in PB (8.7% vs 1.7%; P = 0.01). Multivariate analysis showed risk factors of PB were liver cirrhosis (adjusted odds ratio [aOR], 3.27; 95% confidence interval [CI], 1.50-7.12), infective endocarditis (aOR, 7.13; 95% CI, 1.37-37.12), bone and joint infections (aOR, 3.76; 95% CI, 1.62-8.77), C-reactive protein ≥ 10 mg/dL (aOR, 2.20; 95% CI, 1.22-3.95), metastatic infection (aOR, 7.35; 95% CI, 3.53-15.29), and agr dysfunction (aOR, 2.47; 95% CI, 1.05-5.81). PB occurred in approximately 40% of bacteremia caused by ST72 MRSA with a significantly higher recurrence rate. Patients with risk factors of PB, including liver cirrhosis, high initial CRP, infective endocarditis, or bone and joint infections, might require early aggressive treatment.
Author(s)
정혜민김은실양응미이윤우박정하배성만정지원김민재정용필김성한이상오최상호김양수
Issued Date
2021
Type
Article
Keyword
Agr dysfunctionC-reactive proteinPersistent bacteremiaStaphylococcus aureus
DOI
10.1007/s10096-021-04303-5
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8331
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2550268027&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,C%3Freactive%20protein%20predicts%20persistent%20bacteremia%20caused%20by%20community%3Facquired%20methicillin%3Fresistant%20Staphylococcus%20aureus%20strain&offset=0&pcAvailability=true
Publisher
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
Location
독일
Language
한국어
ISSN
0934-9723
Citation Volume
40
Citation Number
12
Citation Start Page
2497
Citation End Page
2504
Appears in Collections:
Medicine > Medicine
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