| Prevalence and outcomes of antimicrobial treatment for Staphylococcus aureus bacteremia in outpatients with ESRD. | |
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MedLine Citation:
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PMID: 22904350 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Staphylococcus bacteremia is a common and life-threatening medical emergency, but it is treatable with appropriate antibiotic therapy. To identify opportunities that may reduce morbidity and mortality associated with S. aureus, we analyzed data from 293,094 chronic hemodialysis outpatients to characterize practices of antibiotic selection. In the study population, the overall rate of bacteremia was 15.4 per 100 outpatient-years; the incidence rate for methicillin-sensitive (MSSA) was 2.1 per 100 outpatient-years, and the incidence rate for methicillin-resistant (MRSA) S. aureus was 1.9 per 100 outpatient-years. One week after the collection of the index blood culture, 56.1% of outpatients with MSSA bacteremia were receiving vancomycin, and 16.7% of outpatients with MSSA were receiving cefazolin. Among MSSA-bacteremic patients who did not die or get hospitalized 1 week after blood culture collection, use of cefazolin was associated with a 38% lower risk for hospitalization or death compared with vancomycin (adjusted HR=0.62, 95% CI=0.46-0.84). In conclusion, vancomycin is commonly used to treat MSSA bacteremia in outpatients receiving chronic dialysis, but there may be more risk of treatment failure than observed among those individuals who receive a β-lactam antibiotic such as cefazolin. |
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Authors:
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Kevin E Chan; H Shaw Warren; Ravi I Thadhani; David J R Steele; Jeffrey L Hymes; Franklin W Maddux; Raymond M Hakim |
Publication Detail:
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Type: Comparative Study; Journal Article Date: 2012-08-16 |
Journal Detail:
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Title: Journal of the American Society of Nephrology : JASN Volume: 23 ISSN: 1533-3450 ISO Abbreviation: J. Am. Soc. Nephrol. Publication Date: 2012 Sep |
Date Detail:
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Created Date: 2012-09-03 Completed Date: 2012-11-27 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 9013836 Medline TA: J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 1551-9 Citation Subset: IM |
Affiliation:
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Clinical Research Division, Fresenius Medical Care North America, 920 Winter Street, Waltham, MA 02451, USA. kevin.chan@fmc-na.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Bacterial Agents
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therapeutic use Bacteremia / drug therapy*, epidemiology* Cefazolin / therapeutic use* Comorbidity Female Humans Kidney Failure, Chronic / epidemiology*, therapy Longitudinal Studies Male Methicillin-Resistant Staphylococcus aureus Middle Aged Outpatients* Prevalence Renal Dialysis Retrospective Studies Risk Factors Staphylococcal Infections / drug therapy, epidemiology Staphylococcus aureus* Treatment Outcome United States / epidemiology Vancomycin / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 1404-90-6/Vancomycin; 25953-19-9/Cefazolin |
| Comments/Corrections | |
Comment In:
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Nat Rev Nephrol. 2012 Oct;8(10):556
[PMID:
22945487
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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