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Staphylococcus aureus bloodstream infections in Latin America: results of a multinational prospective cohort study

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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


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