Increased mortality associated with meticillin-resistant Staphylococcus aureus (MRSA) infection in the Intensive Care Unit: results from the EPIC II study
Identifieur interne : 001940 ( PascalFrancis/Corpus ); précédent : 001939; suivant : 001941Increased mortality associated with meticillin-resistant Staphylococcus aureus (MRSA) infection in the Intensive Care Unit: results from the EPIC II study
Auteurs : H Kan Hanberger ; Sten Walther ; Marc Leone ; Philip S. Barie ; Jordi Rello ; Jeffrey Lipman ; John C. Marshall ; Antonio Anzueto ; Yasser Sakr ; Peter Pickkers ; Peter Felleiter ; Milo Engoren ; Jean-Louis VincentSource :
- International journal of antimicrobial agents : (Print) [ 0924-8579 ] ; 2011.
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Abstract
Controversy continues regarding whether the presence of meticillin resistance increases mortality risk in Staphylococcus aureus infections. In this study, we assessed the role of meticillin resistance in survival of patients with S. aureus infection included in the EPIC II point-prevalence study of infection in critically ill patients performed on 8 May 2007. Demographic, physiological, bacteriological and therapeutic data were collected for 13 796 adult patients in 1265 participating Intensive Care Units (ICUs) from 75 countries on the study day. ICU and hospital outcomes were recorded. Characteristics of patients with meticillin-sensitive S. aureus (MSSA) and meticillin-resistant S. aureus (MRSA) infections were compared. Co-morbidities, age, Simplified Acute Physiology Score (SAPS) II, site of infection, geographical region and MRSA/MSSA were entered into a multivariate model, and adjusted odds ratios (ORs) [95% confidence interval (CI)] for ICU and hospital mortality rates were calculated. On the study day, 7087 (51%) of the 13 796 patients were classified as infected. There were 494 patients with MRSA infections and 505 patients with MSSA infections. There were no significant differences between the two groups in use of mechanical ventilation or haemofiltration/haemodialysis. Cancer and chronic renal failure were more prevalent in MRSA than in MSSA patients. ICU mortality rates were 29.1% and 20.5%, respectively (P< 0.01 ) and corresponding hospital mortality rates were 36.4% and 27.0% (P< 0.01). Multivariate analysis of hospital mortality for MRSA infection showed an adjusted OR of 1.46 (95% CI 1.03-2.06) (P= 0.03). In ICU patients, MRSA infection is therefore independently associated with an almost 50% higher likelihood of hospital death compared with MSSA infection.
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Format Inist (serveur)
| NO : | PASCAL 11-0420647 INIST |
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| ET : | Increased mortality associated with meticillin-resistant Staphylococcus aureus (MRSA) infection in the Intensive Care Unit: results from the EPIC II study |
| AU : | HANBERGER (Håkan); WALTHER (Sten); LEONE (Marc); BARIE (Philip S.); RELLO (Jordi); LIPMAN (Jeffrey); MARSHALL (John C.); ANZUETO (Antonio); SAKR (Yasser); PICKKERS (Peter); FELLEITER (Peter); ENGOREN (Milo); VINCENT (Jean-Louis) |
| AF : | Division of Infectious Diseases, Institution of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University/Linköping/Suède (1 aut.); Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University/Linköping/Suède (2 aut.); Department of Anesthesiology and Intensive Care Medicine, Nord Hospital/Marseille/France (3 aut.); Department of Surgery, Weill Cornell Medical College, 1300 York Ave., P713A/New York, NY 10021/Etats-Unis (4 aut.); Critical Care Department, Vall d'Hebron University Hospital, CIBERES, VHIR, Universitat Autónoma de Barcelona/Espagne (5 aut.); Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital and Bums Trauma Critical Care Research Centre, University of Queensland/Queensland/Australie (6 aut.); Department of Surgery, University of Toronto, St Michael's Hospital, Toronto/Ontario/Canada (7 aut.); Department of Pulmonary/Critical Care, University of Texas Health Science Center/San Antonio, TX/Etats-Unis (8 aut.); Department of Anesthesiology and Intensive Care, Friedrich-Schiller University/Jena/Allemagne (9 aut.); Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre/Nijmegen/Pays-Bas (10 aut.); Intensive Care Medicine, Swiss Paraplegic Centre/6207 Nottwil/Suisse (11 aut.); Department of Anesthesiology, Mercy St Vincent Medical Center/Toledo, OH/Etats-Unis (12 aut.); Department of Intensive Care, Erasme Hospital, Universite libre de Bruxelles, Route de Lennik 808/1070 Brussels/Belgique (13 aut.) |
| DT : | Publication en série; Niveau analytique |
| SO : | International journal of antimicrobial agents : (Print); ISSN 0924-8579; Pays-Bas; Da. 2011; Vol. 38; No. 4; Pp. 331-335; Bibl. 30 ref. |
| LA : | Anglais |
| EA : | Controversy continues regarding whether the presence of meticillin resistance increases mortality risk in Staphylococcus aureus infections. In this study, we assessed the role of meticillin resistance in survival of patients with S. aureus infection included in the EPIC II point-prevalence study of infection in critically ill patients performed on 8 May 2007. Demographic, physiological, bacteriological and therapeutic data were collected for 13 796 adult patients in 1265 participating Intensive Care Units (ICUs) from 75 countries on the study day. ICU and hospital outcomes were recorded. Characteristics of patients with meticillin-sensitive S. aureus (MSSA) and meticillin-resistant S. aureus (MRSA) infections were compared. Co-morbidities, age, Simplified Acute Physiology Score (SAPS) II, site of infection, geographical region and MRSA/MSSA were entered into a multivariate model, and adjusted odds ratios (ORs) [95% confidence interval (CI)] for ICU and hospital mortality rates were calculated. On the study day, 7087 (51%) of the 13 796 patients were classified as infected. There were 494 patients with MRSA infections and 505 patients with MSSA infections. There were no significant differences between the two groups in use of mechanical ventilation or haemofiltration/haemodialysis. Cancer and chronic renal failure were more prevalent in MRSA than in MSSA patients. ICU mortality rates were 29.1% and 20.5%, respectively (P< 0.01 ) and corresponding hospital mortality rates were 36.4% and 27.0% (P< 0.01). Multivariate analysis of hospital mortality for MRSA infection showed an adjusted OR of 1.46 (95% CI 1.03-2.06) (P= 0.03). In ICU patients, MRSA infection is therefore independently associated with an almost 50% higher likelihood of hospital death compared with MSSA infection. |
| CC : | 002B02S; 002B05B02N; 002B05B02M |
| FD : | Mortalité; Staphylococcus aureus; Staphylococcie; Unité soin intensif; Test sensibilité médicamenteuse; Antimicrobien; Résistance; Bactériémie; Syndrome septique; Malade état grave; Souche résistante méticilline |
| FG : | Micrococcaceae; Micrococcales; Bactérie; Bactériose; Infection |
| ED : | Mortality; Staphylococcus aureus; Staphylococcal infection; Intensive care unit; Drug susceptibility test; Antimicrobial agent; Resistance; Bacteremia; Sepsis syndrome; Critically ill |
| EG : | Micrococcaceae; Micrococcales; Bacteria; Bacteriosis; Infection |
| SD : | Mortalidad; Staphylococcus aureus; Estafilococia; Unidad terapia intensiva; Prueba sensibilidad medicamentosa; Antimicrobiano; Resistencia; Bacteriemia; Séptico síndrome; Enfermo estado grave |
| LO : | INIST-22211.354000508999140100 |
| ID : | 11-0420647 |
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Marshall</name><affiliation><inist:fA14 i1="07"><s1>Department of Surgery, University of Toronto, St Michael's Hospital, Toronto</s1><s2>Ontario</s2><s3>CAN</s3><sZ>7 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Anzueto, Antonio" sort="Anzueto, Antonio" uniqKey="Anzueto A" first="Antonio" last="Anzueto">Antonio Anzueto</name><affiliation><inist:fA14 i1="08"><s1>Department of Pulmonary/Critical Care, University of Texas Health Science Center</s1><s2>San Antonio, TX</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Sakr, Yasser" sort="Sakr, Yasser" uniqKey="Sakr Y" first="Yasser" last="Sakr">Yasser Sakr</name><affiliation><inist:fA14 i1="09"><s1>Department of Anesthesiology and Intensive Care, Friedrich-Schiller University</s1><s2>Jena</s2><s3>DEU</s3><sZ>9 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Pickkers, Peter" sort="Pickkers, Peter" uniqKey="Pickkers P" first="Peter" last="Pickkers">Peter Pickkers</name><affiliation><inist:fA14 i1="10"><s1>Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre</s1><s2>Nijmegen</s2><s3>NLD</s3><sZ>10 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Felleiter, Peter" sort="Felleiter, Peter" uniqKey="Felleiter P" first="Peter" last="Felleiter">Peter Felleiter</name><affiliation><inist:fA14 i1="11"><s1>Intensive Care Medicine, Swiss Paraplegic Centre</s1><s2>6207 Nottwil</s2><s3>CHE</s3><sZ>11 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Engoren, Milo" sort="Engoren, Milo" uniqKey="Engoren M" first="Milo" last="Engoren">Milo Engoren</name><affiliation><inist:fA14 i1="12"><s1>Department of Anesthesiology, Mercy St Vincent Medical Center</s1><s2>Toledo, OH</s2><s3>USA</s3><sZ>12 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Vincent, Jean Louis" sort="Vincent, Jean Louis" uniqKey="Vincent J" first="Jean-Louis" last="Vincent">Jean-Louis Vincent</name><affiliation><inist:fA14 i1="13"><s1>Department of Intensive Care, Erasme Hospital, Universite libre de Bruxelles, Route de Lennik 808</s1><s2>1070 Brussels</s2><s3>BEL</s3><sZ>13 aut.</sZ></inist:fA14></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">11-0420647</idno><date when="2011">2011</date><idno type="stanalyst">PASCAL 11-0420647 INIST</idno><idno type="RBID">Pascal:11-0420647</idno><idno type="wicri:Area/PascalFrancis/Corpus">001940</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Increased mortality associated with meticillin-resistant Staphylococcus aureus (MRSA) infection in the Intensive Care Unit: results from the EPIC II study</title><author><name sortKey="Hanberger, H Kan" sort="Hanberger, H Kan" uniqKey="Hanberger H" first="H Kan" last="Hanberger">H Kan Hanberger</name><affiliation><inist:fA14 i1="01"><s1>Division of Infectious Diseases, Institution of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University</s1><s2>Linköping</s2><s3>SWE</s3><sZ>1 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Walther, Sten" sort="Walther, Sten" uniqKey="Walther S" first="Sten" last="Walther">Sten Walther</name><affiliation><inist:fA14 i1="02"><s1>Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University</s1><s2>Linköping</s2><s3>SWE</s3><sZ>2 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Leone, Marc" sort="Leone, Marc" uniqKey="Leone M" first="Marc" last="Leone">Marc Leone</name><affiliation><inist:fA14 i1="03"><s1>Department of Anesthesiology and Intensive Care Medicine, Nord Hospital</s1><s2>Marseille</s2><s3>FRA</s3><sZ>3 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Barie, Philip S" sort="Barie, Philip S" uniqKey="Barie P" first="Philip S." last="Barie">Philip S. Barie</name><affiliation><inist:fA14 i1="04"><s1>Department of Surgery, Weill Cornell Medical College, 1300 York Ave., P713A</s1><s2>New York, NY 10021</s2><s3>USA</s3><sZ>4 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Rello, Jordi" sort="Rello, Jordi" uniqKey="Rello J" first="Jordi" last="Rello">Jordi Rello</name><affiliation><inist:fA14 i1="05"><s1>Critical Care Department, Vall d'Hebron University Hospital, CIBERES, VHIR, Universitat Autónoma de Barcelona</s1><s3>ESP</s3><sZ>5 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Lipman, Jeffrey" sort="Lipman, Jeffrey" uniqKey="Lipman J" first="Jeffrey" last="Lipman">Jeffrey Lipman</name><affiliation><inist:fA14 i1="06"><s1>Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital and Bums Trauma Critical Care Research Centre, University of Queensland</s1><s2>Queensland</s2><s3>AUS</s3><sZ>6 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Marshall, John C" sort="Marshall, John C" uniqKey="Marshall J" first="John C." last="Marshall">John C. Marshall</name><affiliation><inist:fA14 i1="07"><s1>Department of Surgery, University of Toronto, St Michael's Hospital, Toronto</s1><s2>Ontario</s2><s3>CAN</s3><sZ>7 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Anzueto, Antonio" sort="Anzueto, Antonio" uniqKey="Anzueto A" first="Antonio" last="Anzueto">Antonio Anzueto</name><affiliation><inist:fA14 i1="08"><s1>Department of Pulmonary/Critical Care, University of Texas Health Science Center</s1><s2>San Antonio, TX</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Sakr, Yasser" sort="Sakr, Yasser" uniqKey="Sakr Y" first="Yasser" last="Sakr">Yasser Sakr</name><affiliation><inist:fA14 i1="09"><s1>Department of Anesthesiology and Intensive Care, Friedrich-Schiller University</s1><s2>Jena</s2><s3>DEU</s3><sZ>9 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Pickkers, Peter" sort="Pickkers, Peter" uniqKey="Pickkers P" first="Peter" last="Pickkers">Peter Pickkers</name><affiliation><inist:fA14 i1="10"><s1>Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre</s1><s2>Nijmegen</s2><s3>NLD</s3><sZ>10 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Felleiter, Peter" sort="Felleiter, Peter" uniqKey="Felleiter P" first="Peter" last="Felleiter">Peter Felleiter</name><affiliation><inist:fA14 i1="11"><s1>Intensive Care Medicine, Swiss Paraplegic Centre</s1><s2>6207 Nottwil</s2><s3>CHE</s3><sZ>11 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Engoren, Milo" sort="Engoren, Milo" uniqKey="Engoren M" first="Milo" last="Engoren">Milo Engoren</name><affiliation><inist:fA14 i1="12"><s1>Department of Anesthesiology, Mercy St Vincent Medical Center</s1><s2>Toledo, OH</s2><s3>USA</s3><sZ>12 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Vincent, Jean Louis" sort="Vincent, Jean Louis" uniqKey="Vincent J" first="Jean-Louis" last="Vincent">Jean-Louis Vincent</name><affiliation><inist:fA14 i1="13"><s1>Department of Intensive Care, Erasme Hospital, Universite libre de Bruxelles, Route de Lennik 808</s1><s2>1070 Brussels</s2><s3>BEL</s3><sZ>13 aut.</sZ></inist:fA14></affiliation></author></analytic><series><title level="j" type="main">International journal of antimicrobial agents : (Print)</title><title level="j" type="abbreviated">Int. j. antimicrob. agents : (Print)</title><idno type="ISSN">0924-8579</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">International journal of antimicrobial agents : (Print)</title><title level="j" type="abbreviated">Int. j. antimicrob. agents : (Print)</title><idno type="ISSN">0924-8579</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antimicrobial agent</term><term>Bacteremia</term><term>Critically ill</term><term>Drug susceptibility test</term><term>Intensive care unit</term><term>Mortality</term><term>Resistance</term><term>Sepsis syndrome</term><term>Staphylococcal infection</term><term>Staphylococcus aureus</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Mortalité</term><term>Staphylococcus aureus</term><term>Staphylococcie</term><term>Unité soin intensif</term><term>Test sensibilité médicamenteuse</term><term>Antimicrobien</term><term>Résistance</term><term>Bactériémie</term><term>Syndrome septique</term><term>Malade état grave</term><term>Souche résistante méticilline</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Controversy continues regarding whether the presence of meticillin resistance increases mortality risk in Staphylococcus aureus infections. In this study, we assessed the role of meticillin resistance in survival of patients with S. aureus infection included in the EPIC II point-prevalence study of infection in critically ill patients performed on 8 May 2007. Demographic, physiological, bacteriological and therapeutic data were collected for 13 796 adult patients in 1265 participating Intensive Care Units (ICUs) from 75 countries on the study day. ICU and hospital outcomes were recorded. Characteristics of patients with meticillin-sensitive S. aureus (MSSA) and meticillin-resistant S. aureus (MRSA) infections were compared. Co-morbidities, age, Simplified Acute Physiology Score (SAPS) II, site of infection, geographical region and MRSA/MSSA were entered into a multivariate model, and adjusted odds ratios (ORs) [95% confidence interval (CI)] for ICU and hospital mortality rates were calculated. On the study day, 7087 (51%) of the 13 796 patients were classified as infected. There were 494 patients with MRSA infections and 505 patients with MSSA infections. There were no significant differences between the two groups in use of mechanical ventilation or haemofiltration/haemodialysis. Cancer and chronic renal failure were more prevalent in MRSA than in MSSA patients. ICU mortality rates were 29.1% and 20.5%, respectively (P< 0.01 ) and corresponding hospital mortality rates were 36.4% and 27.0% (P< 0.01). Multivariate analysis of hospital mortality for MRSA infection showed an adjusted OR of 1.46 (95% CI 1.03-2.06) (P<sub>=</sub> 0.03). In ICU patients, MRSA infection is therefore independently associated with an almost 50% higher likelihood of hospital death compared with MSSA infection.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0924-8579</s0></fA01><fA03 i2="1"><s0>Int. j. antimicrob. agents : (Print)</s0></fA03><fA05><s2>38</s2></fA05><fA06><s2>4</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Increased mortality associated with meticillin-resistant Staphylococcus aureus (MRSA) infection in the Intensive Care Unit: results from the EPIC II study</s1></fA08><fA11 i1="01" i2="1"><s1>HANBERGER (Håkan)</s1></fA11><fA11 i1="02" i2="1"><s1>WALTHER (Sten)</s1></fA11><fA11 i1="03" i2="1"><s1>LEONE (Marc)</s1></fA11><fA11 i1="04" i2="1"><s1>BARIE (Philip S.)</s1></fA11><fA11 i1="05" i2="1"><s1>RELLO (Jordi)</s1></fA11><fA11 i1="06" i2="1"><s1>LIPMAN (Jeffrey)</s1></fA11><fA11 i1="07" i2="1"><s1>MARSHALL (John C.)</s1></fA11><fA11 i1="08" i2="1"><s1>ANZUETO (Antonio)</s1></fA11><fA11 i1="09" i2="1"><s1>SAKR (Yasser)</s1></fA11><fA11 i1="10" i2="1"><s1>PICKKERS (Peter)</s1></fA11><fA11 i1="11" i2="1"><s1>FELLEITER (Peter)</s1></fA11><fA11 i1="12" i2="1"><s1>ENGOREN (Milo)</s1></fA11><fA11 i1="13" i2="1"><s1>VINCENT (Jean-Louis)</s1></fA11><fA14 i1="01"><s1>Division of Infectious Diseases, Institution of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University</s1><s2>Linköping</s2><s3>SWE</s3><sZ>1 aut.</sZ></fA14><fA14 i1="02"><s1>Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University</s1><s2>Linköping</s2><s3>SWE</s3><sZ>2 aut.</sZ></fA14><fA14 i1="03"><s1>Department of Anesthesiology and Intensive Care Medicine, Nord Hospital</s1><s2>Marseille</s2><s3>FRA</s3><sZ>3 aut.</sZ></fA14><fA14 i1="04"><s1>Department of Surgery, Weill Cornell Medical College, 1300 York Ave., P713A</s1><s2>New York, NY 10021</s2><s3>USA</s3><sZ>4 aut.</sZ></fA14><fA14 i1="05"><s1>Critical Care Department, Vall d'Hebron University Hospital, CIBERES, VHIR, Universitat Autónoma de Barcelona</s1><s3>ESP</s3><sZ>5 aut.</sZ></fA14><fA14 i1="06"><s1>Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital and Bums Trauma Critical Care Research Centre, University of Queensland</s1><s2>Queensland</s2><s3>AUS</s3><sZ>6 aut.</sZ></fA14><fA14 i1="07"><s1>Department of Surgery, University of Toronto, St Michael's Hospital, Toronto</s1><s2>Ontario</s2><s3>CAN</s3><sZ>7 aut.</sZ></fA14><fA14 i1="08"><s1>Department of Pulmonary/Critical Care, University of Texas Health Science Center</s1><s2>San Antonio, TX</s2><s3>USA</s3><sZ>8 aut.</sZ></fA14><fA14 i1="09"><s1>Department of Anesthesiology and Intensive Care, Friedrich-Schiller University</s1><s2>Jena</s2><s3>DEU</s3><sZ>9 aut.</sZ></fA14><fA14 i1="10"><s1>Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre</s1><s2>Nijmegen</s2><s3>NLD</s3><sZ>10 aut.</sZ></fA14><fA14 i1="11"><s1>Intensive Care Medicine, Swiss Paraplegic Centre</s1><s2>6207 Nottwil</s2><s3>CHE</s3><sZ>11 aut.</sZ></fA14><fA14 i1="12"><s1>Department of Anesthesiology, Mercy St Vincent Medical Center</s1><s2>Toledo, OH</s2><s3>USA</s3><sZ>12 aut.</sZ></fA14><fA14 i1="13"><s1>Department of Intensive Care, Erasme Hospital, Universite libre de Bruxelles, Route de Lennik 808</s1><s2>1070 Brussels</s2><s3>BEL</s3><sZ>13 aut.</sZ></fA14><fA20><s1>331-335</s1></fA20><fA21><s1>2011</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>22211</s2><s5>354000508999140100</s5></fA43><fA44><s0>0000</s0><s1>© 2011 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>30 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>11-0420647</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>International journal of antimicrobial agents : (Print)</s0></fA64><fA66 i1="01"><s0>NLD</s0></fA66><fC01 i1="01" l="ENG"><s0>Controversy continues regarding whether the presence of meticillin resistance increases mortality risk in Staphylococcus aureus infections. In this study, we assessed the role of meticillin resistance in survival of patients with S. aureus infection included in the EPIC II point-prevalence study of infection in critically ill patients performed on 8 May 2007. Demographic, physiological, bacteriological and therapeutic data were collected for 13 796 adult patients in 1265 participating Intensive Care Units (ICUs) from 75 countries on the study day. ICU and hospital outcomes were recorded. Characteristics of patients with meticillin-sensitive S. aureus (MSSA) and meticillin-resistant S. aureus (MRSA) infections were compared. Co-morbidities, age, Simplified Acute Physiology Score (SAPS) II, site of infection, geographical region and MRSA/MSSA were entered into a multivariate model, and adjusted odds ratios (ORs) [95% confidence interval (CI)] for ICU and hospital mortality rates were calculated. On the study day, 7087 (51%) of the 13 796 patients were classified as infected. There were 494 patients with MRSA infections and 505 patients with MSSA infections. There were no significant differences between the two groups in use of mechanical ventilation or haemofiltration/haemodialysis. Cancer and chronic renal failure were more prevalent in MRSA than in MSSA patients. ICU mortality rates were 29.1% and 20.5%, respectively (P< 0.01 ) and corresponding hospital mortality rates were 36.4% and 27.0% (P< 0.01). Multivariate analysis of hospital mortality for MRSA infection showed an adjusted OR of 1.46 (95% CI 1.03-2.06) (P<sub>=</sub> 0.03). In ICU patients, MRSA infection is therefore independently associated with an almost 50% higher likelihood of hospital death compared with MSSA infection.</s0></fC01><fC02 i1="01" i2="X"><s0>002B02S</s0></fC02><fC02 i1="02" i2="X"><s0>002B05B02N</s0></fC02><fC02 i1="03" i2="X"><s0>002B05B02M</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Mortalité</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Mortality</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Mortalidad</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Staphylococcus aureus</s0><s2>NS</s2><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Staphylococcus aureus</s0><s2>NS</s2><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Staphylococcus aureus</s0><s2>NS</s2><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Staphylococcie</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Staphylococcal infection</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Estafilococia</s0><s5>03</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Unité soin intensif</s0><s5>05</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Intensive care unit</s0><s5>05</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Unidad terapia intensiva</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Test sensibilité médicamenteuse</s0><s5>06</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Drug susceptibility test</s0><s5>06</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Prueba sensibilidad medicamentosa</s0><s5>06</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Antimicrobien</s0><s5>07</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Antimicrobial agent</s0><s5>07</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Antimicrobiano</s0><s5>07</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Résistance</s0><s5>08</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Resistance</s0><s5>08</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Resistencia</s0><s5>08</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Bactériémie</s0><s5>09</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>Bacteremia</s0><s5>09</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Bacteriemia</s0><s5>09</s5></fC03><fC03 i1="09" i2="X" l="FRE"><s0>Syndrome septique</s0><s2>NM</s2><s5>10</s5></fC03><fC03 i1="09" i2="X" l="ENG"><s0>Sepsis syndrome</s0><s2>NM</s2><s5>10</s5></fC03><fC03 i1="09" i2="X" l="SPA"><s0>Séptico síndrome</s0><s2>NM</s2><s5>10</s5></fC03><fC03 i1="10" i2="X" l="FRE"><s0>Malade état grave</s0><s5>11</s5></fC03><fC03 i1="10" i2="X" l="ENG"><s0>Critically ill</s0><s5>11</s5></fC03><fC03 i1="10" i2="X" l="SPA"><s0>Enfermo estado grave</s0><s5>11</s5></fC03><fC03 i1="11" i2="X" l="FRE"><s0>Souche résistante méticilline</s0><s4>INC</s4><s5>86</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Micrococcaceae</s0><s2>NS</s2></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Micrococcaceae</s0><s2>NS</s2></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Micrococcaceae</s0><s2>NS</s2></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Micrococcales</s0><s2>NS</s2></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Micrococcales</s0><s2>NS</s2></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Micrococcales</s0><s2>NS</s2></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Bactérie</s0></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Bacteria</s0></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Bacteria</s0></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Bactériose</s0></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Bacteriosis</s0></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Bacteriosis</s0></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Infection</s0></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Infection</s0></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Infección</s0></fC07><fN21><s1>290</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard><server><NO>PASCAL 11-0420647 INIST</NO><ET>Increased mortality associated with meticillin-resistant Staphylococcus aureus (MRSA) infection in the Intensive Care Unit: results from the EPIC II study</ET><AU>HANBERGER (Håkan); WALTHER (Sten); LEONE (Marc); BARIE (Philip S.); RELLO (Jordi); LIPMAN (Jeffrey); MARSHALL (John C.); ANZUETO (Antonio); SAKR (Yasser); PICKKERS (Peter); FELLEITER (Peter); ENGOREN (Milo); VINCENT (Jean-Louis)</AU><AF>Division of Infectious Diseases, Institution of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University/Linköping/Suède (1 aut.); Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University/Linköping/Suède (2 aut.); Department of Anesthesiology and Intensive Care Medicine, Nord Hospital/Marseille/France (3 aut.); Department of Surgery, Weill Cornell Medical College, 1300 York Ave., P713A/New York, NY 10021/Etats-Unis (4 aut.); Critical Care Department, Vall d'Hebron University Hospital, CIBERES, VHIR, Universitat Autónoma de Barcelona/Espagne (5 aut.); Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital and Bums Trauma Critical Care Research Centre, University of Queensland/Queensland/Australie (6 aut.); Department of Surgery, University of Toronto, St Michael's Hospital, Toronto/Ontario/Canada (7 aut.); Department of Pulmonary/Critical Care, University of Texas Health Science Center/San Antonio, TX/Etats-Unis (8 aut.); Department of Anesthesiology and Intensive Care, Friedrich-Schiller University/Jena/Allemagne (9 aut.); Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre/Nijmegen/Pays-Bas (10 aut.); Intensive Care Medicine, Swiss Paraplegic Centre/6207 Nottwil/Suisse (11 aut.); Department of Anesthesiology, Mercy St Vincent Medical Center/Toledo, OH/Etats-Unis (12 aut.); Department of Intensive Care, Erasme Hospital, Universite libre de Bruxelles, Route de Lennik 808/1070 Brussels/Belgique (13 aut.)</AF><DT>Publication en série; Niveau analytique</DT><SO>International journal of antimicrobial agents : (Print); ISSN 0924-8579; Pays-Bas; Da. 2011; Vol. 38; No. 4; Pp. 331-335; Bibl. 30 ref.</SO><LA>Anglais</LA><EA>Controversy continues regarding whether the presence of meticillin resistance increases mortality risk in Staphylococcus aureus infections. In this study, we assessed the role of meticillin resistance in survival of patients with S. aureus infection included in the EPIC II point-prevalence study of infection in critically ill patients performed on 8 May 2007. Demographic, physiological, bacteriological and therapeutic data were collected for 13 796 adult patients in 1265 participating Intensive Care Units (ICUs) from 75 countries on the study day. ICU and hospital outcomes were recorded. Characteristics of patients with meticillin-sensitive S. aureus (MSSA) and meticillin-resistant S. aureus (MRSA) infections were compared. Co-morbidities, age, Simplified Acute Physiology Score (SAPS) II, site of infection, geographical region and MRSA/MSSA were entered into a multivariate model, and adjusted odds ratios (ORs) [95% confidence interval (CI)] for ICU and hospital mortality rates were calculated. On the study day, 7087 (51%) of the 13 796 patients were classified as infected. There were 494 patients with MRSA infections and 505 patients with MSSA infections. There were no significant differences between the two groups in use of mechanical ventilation or haemofiltration/haemodialysis. Cancer and chronic renal failure were more prevalent in MRSA than in MSSA patients. ICU mortality rates were 29.1% and 20.5%, respectively (P< 0.01 ) and corresponding hospital mortality rates were 36.4% and 27.0% (P< 0.01). Multivariate analysis of hospital mortality for MRSA infection showed an adjusted OR of 1.46 (95% CI 1.03-2.06) (P<sub>=</sub> 0.03). In ICU patients, MRSA infection is therefore independently associated with an almost 50% higher likelihood of hospital death compared with MSSA infection.</EA><CC>002B02S; 002B05B02N; 002B05B02M</CC><FD>Mortalité; Staphylococcus aureus; Staphylococcie; Unité soin intensif; Test sensibilité médicamenteuse; Antimicrobien; Résistance; Bactériémie; Syndrome septique; Malade état grave; Souche résistante méticilline</FD><FG>Micrococcaceae; Micrococcales; Bactérie; Bactériose; Infection</FG><ED>Mortality; Staphylococcus aureus; Staphylococcal infection; Intensive care unit; Drug susceptibility test; Antimicrobial agent; Resistance; Bacteremia; Sepsis syndrome; Critically ill</ED><EG>Micrococcaceae; Micrococcales; Bacteria; Bacteriosis; Infection</EG><SD>Mortalidad; Staphylococcus aureus; Estafilococia; Unidad terapia intensiva; Prueba sensibilidad medicamentosa; Antimicrobiano; Resistencia; Bacteriemia; Séptico síndrome; Enfermo estado grave</SD><LO>INIST-22211.354000508999140100</LO><ID>11-0420647</ID></server></inist></record>Pour manipuler ce document sous Unix (Dilib)
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