dc.contributor.author |
Seas Ramos, Carlos Rafael |
|
dc.contributor.author |
García Apac, Coralith Marlinda |
|
dc.contributor.author |
Salles, M. J. |
|
dc.contributor.author |
Labarca, J. |
|
dc.contributor.author |
Luna, C. |
|
dc.contributor.author |
Alvarez-Moreno, C. |
|
dc.contributor.author |
Mejía-Villatoro, C. |
|
dc.contributor.author |
Zurita, J. |
|
dc.contributor.author |
Guzmán-Blanco, M. |
|
dc.contributor.author |
Rodríguez-Noriega, E. |
|
dc.contributor.author |
Reyes, J. |
|
dc.contributor.author |
Arias, C. A. |
|
dc.contributor.author |
Cárcamo Cavagnaro, César Paul Eugenio |
|
dc.contributor.author |
Gotuzzo Herencia, José Eduardo |
|
dc.date.accessioned |
2018-03-22T23:38:48Z |
|
dc.date.available |
2018-03-22T23:38:48Z |
|
dc.date.issued |
2017 |
|
dc.identifier.uri |
https://hdl.handle.net/20.500.12866/1470 |
|
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. |
en_US |
dc.language.iso |
eng |
|
dc.publisher |
Oxford University Press |
|
dc.relation.ispartofseries |
Journal of Antimicrobial Chemotherapy |
|
dc.rights |
info:eu-repo/semantics/restrictedAccess |
|
dc.rights.uri |
https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es |
|
dc.subject |
staphylococcus aureus |
en_US |
dc.subject |
bacteremia |
en_US |
dc.subject |
epidemiology |
en_US |
dc.subject |
heterogeneity |
en_US |
dc.subject |
follow-up |
en_US |
dc.subject |
lactams |
en_US |
dc.subject |
latin america |
en_US |
dc.subject |
length of stay |
en_US |
dc.subject |
prospective studies |
en_US |
dc.subject |
mortality |
en_US |
dc.subject |
methicillin-resistant staphylococcus aureus |
en_US |
dc.subject |
bloodstream infections |
en_US |
dc.subject |
methicillin-susceptible staphylococcus aureus |
en_US |
dc.subject |
per protocol analysis |
en_US |
dc.subject |
sensitivity analysis |
en_US |
dc.subject |
methicillin-resistant staphylococcus aureus infection |
en_US |
dc.title |
Staphylococcus aureus bloodstream infections in Latin America: results of a multinational prospective cohort study |
en_US |
dc.type |
info:eu-repo/semantics/article |
|
dc.identifier.doi |
https://doi.org/10.1093/jac/dkx350 |
|
dc.subject.ocde |
https://purl.org/pe-repo/ocde/ford#3.03.08 |
|
dc.subject.ocde |
https://purl.org/pe-repo/ocde/ford#3.01.05 |
|
dc.subject.ocde |
https://purl.org/pe-repo/ocde/ford#1.06.01 |
|
dc.relation.issn |
1460-2091 |
|