KRUMMI K, PERL TM, SONG X, CARMELI Y, COSGROVE SE; Interscience Conference on Antimicrobial Agents and Chemotherapy (43rd: 2003: Chicago, Ill.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2003 Sep 14-17; 43: abstract no. K-1742.

Johns Hopkins Medical Institutions, Baltimore, MD.

BACKGROUND: FQ exposure has been associated with MRSA colonization and infection in some studies. This study examines the relationship between exposure to different FQs [ciprofloxacin (CP), levofloxacin (LV), and gatifloxacin (GT)] and subsequent MRSA BSI. METHODS: We conducted a matched case-control study from 1/99-9/02. 197 cases who developed a nosocomial MRSA BSI were 1:2 matched on admission date (+/-15 days) & hospital unit to 381 controls who were hospitalized > 48 hours & did not develop a S. aureus (SA) BSI. Data were from hospital databases & chart review. Multivariable analysis was used to adjust for possible confounding. RESULTS: Cases and controls were similar in age (mean, 55 years), length of stay prior to BSI or discharge (20 vs 18 days, p = 0.54) comorbidities, hospital events (ICU stay 51 vs 47%, p = 0.36; surgery 35 vs 36%, p = 0.82; central line 62 vs 63%, p = 0.95), and antimicrobial (AM) exposures: CP 26 vs 23%, p = 0.5; LV 7.6 vs 7.4%, p = 0.45; GT 15 vs 13%, p = 0.91; 3rd generation cephalosporins (GC) 6.6 vs 8.7%, p = 0.39; 4th GC 7.6 vs 8.9%, p = 0.59; carbapenems 7.6 vs 6.8%, p = 0.73; anti-SA penicillins 6 vs 21%, p = 0.18; beta-lactam/inhibitor (BL/I) 23 vs 28%, p = 0.16; vancomycin both 29%, p = 0.99; metronidazole 21 vs 15%, p = 0.06. Cases and controls differed in having a history of MRSA isolation (51 vs 8.7%, p<0.001) & clindamycin exposure (19 vs 12%, p = 0.05). Independent risk factors for nosocomial MRSA BSI included previous isolation of MRSA (OR= 14.3, p < 0.001). Exposure to BL/I was protective against MRSA BSI (OR= 0.47, p=0.012). FQ exposure was not associated with developing MRSA BSI (CP OR = 1.2, p = 0.55; LV OR = 0.9, p = 0.83; GT OR = 1.1, p = 0.81). CONCLUSIONS: In this study, FQ & other AM exposures were not associated with subsequent MRSA BSI when infected cases were compared to hospital controls. The protective effect of BL/I on developing MRSA BSI requires further investigation.

Publication Types:

• Meeting Abstracts

Keywords:

• Case-Control Studies
• Communicable Diseases
• Fluoroquinolones
• Hospitals
• Humans
• Intensive Care Units
• Risk Factors
• Staphylococcal Infections
• Staphylococcus aureus
• gatifloxacin
• injuries

Other ID:

• GWAIDS0026468

UI: 102266092

From Meeting Abstracts