Epidemiology of Methicillin-Resistant Staphylococcus aureus Diabetic Foot Infections in a Large Academic Hospital: Implications for Antimicrobial Stewardship
Publication Date
August 24, 2016
Journal
PLOS ONE
Authors
Kelly R. Reveles, Bryson M. Duhon, Robert J. Moore, Elizabeth O. Hand, et al
Volume
11
Issue
8
Pages
e0161658
DOI
http://doi.org/10.1371/journal.pone.0161658
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0161658
Scopus
84990046035
Mendeley
http://www.mendeley.com/research/epidemiology-methicillinresistant-staphylococcus-aureus-diabetic-foot-infections-large-academic-hosp-3
Events
Loading … Spinner

Mendeley | Further Information

{"title"=>"Epidemiology of methicillin-resistant Staphylococcus aureus diabetic foot infections in a large academic hospital: Implications for antimicrobial stewardship", "type"=>"journal", "authors"=>[{"first_name"=>"Kelly R.", "last_name"=>"Reveles", "scopus_author_id"=>"56197159900"}, {"first_name"=>"Bryson M.", "last_name"=>"Duhon", "scopus_author_id"=>"55791492600"}, {"first_name"=>"Robert J.", "last_name"=>"Moore", "scopus_author_id"=>"57191432761"}, {"first_name"=>"Elizabeth O.", "last_name"=>"Hand", "scopus_author_id"=>"56318854500"}, {"first_name"=>"Crystal K.", "last_name"=>"Howell", "scopus_author_id"=>"57038170100"}], "year"=>2016, "source"=>"PLoS ONE", "identifiers"=>{"doi"=>"10.1371/journal.pone.0161658", "sgr"=>"84990046035", "pmid"=>"27556897", "issn"=>"19326203", "scopus"=>"2-s2.0-84990046035", "pui"=>"612518363"}, "id"=>"17c67086-8421-3ec0-9ed1-62bda87e5574", "abstract"=>"INTRODUCTION Diabetic foot infections (DFIs) are the leading cause of non-traumatic lower extremity amputations in the United States. Antimicrobials active against methicillin-resistant Staphylococcus aureus (MRSA) are recommended in patients with associated risk factors; however, limited data exist to support these recommendations. Due to the changing epidemiology of MRSA, and the consequences of unnecessary antibiotic therapy, guidance regarding the necessity of empirical MRSA coverage in DFIs is needed. We sought to 1) describe the prevalence of MRSA DFIs at our institution and compare to the proportion of patients who receive MRSA antibiotic coverage and 2) identify risk factors for MRSA DFI. METHODS This was a retrospective cohort study of all adult, culture-positive DFI patients managed at University Hospital, San Antonio, TX between January 1, 2010 and September 1, 2014. Patient eligibility included a principal ICD-9-CM discharge diagnosis code for foot infection and a secondary diagnosis of diabetes. The primary outcome was MRSA identified in the wound culture. Independent variables assessed included patient demographics, comorbidities, prior hospitalization, DFI therapies, prior antibiotics, prior MRSA infection, and laboratory values. Multivariable logistic regression was used to identify risk factors for MRSA DFI. RESULTS Overall, 318 patients met inclusion criteria. Patients were predominantly Hispanic (79%) and male (69%). Common comorbidities included hypertension (76%), dyslipidemia (52%), and obesity (49%). S. aureus was present in 46% of culture-positive DFIs (MRSA, 15%). A total of 273 patients (86%) received MRSA antibiotic coverage, resulting in 71% unnecessary use. Male gender (OR 3.09, 95% CI 1.37-7.99) and bone involvement (OR 1.93, 1.00-3.78) were found to be independent risk factors for MRSA DFI. CONCLUSIONS Although MRSA was the causative pathogen in a small number of DFI, antibiotic coverage targeted against MRSA was unnecessarily high.", "link"=>"http://www.mendeley.com/research/epidemiology-methicillinresistant-staphylococcus-aureus-diabetic-foot-infections-large-academic-hosp-3", "reader_count"=>22, "reader_count_by_academic_status"=>{"Unspecified"=>3, "Professor > Associate Professor"=>1, "Student > Doctoral Student"=>4, "Researcher"=>2, "Student > Ph. D. Student"=>2, "Other"=>2, "Student > Master"=>3, "Student > Bachelor"=>4, "Lecturer"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>3, "Professor > Associate Professor"=>1, "Student > Doctoral Student"=>4, "Researcher"=>2, "Student > Ph. D. Student"=>2, "Other"=>2, "Student > Master"=>3, "Student > Bachelor"=>4, "Lecturer"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>5, "Nursing and Health Professions"=>2, "Biochemistry, Genetics and Molecular Biology"=>1, "Medicine and Dentistry"=>10, "Agricultural and Biological Sciences"=>2, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>10}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Unspecified"=>{"Unspecified"=>5}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}}, "group_count"=>0}

Scopus | Further Information

{"@_fa"=>"true", "link"=>[{"@_fa"=>"true", "@ref"=>"self", "@href"=>"https://api.elsevier.com/content/abstract/scopus_id/84990046035"}, {"@_fa"=>"true", "@ref"=>"author-affiliation", "@href"=>"https://api.elsevier.com/content/abstract/scopus_id/84990046035?field=author,affiliation"}, {"@_fa"=>"true", "@ref"=>"scopus", "@href"=>"https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84990046035&origin=inward"}, {"@_fa"=>"true", "@ref"=>"scopus-citedby", "@href"=>"https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=84990046035&origin=inward"}], "prism:url"=>"https://api.elsevier.com/content/abstract/scopus_id/84990046035", "dc:identifier"=>"SCOPUS_ID:84990046035", "eid"=>"2-s2.0-84990046035", "dc:title"=>"Epidemiology of methicillin-resistant Staphylococcus aureus diabetic foot infections in a large academic hospital: Implications for antimicrobial stewardship", "dc:creator"=>"Reveles K.", "prism:publicationName"=>"PLoS ONE", "prism:eIssn"=>"19326203", "prism:volume"=>"11", "prism:issueIdentifier"=>"8", "prism:pageRange"=>nil, "prism:coverDate"=>"2016-08-01", "prism:coverDisplayDate"=>"August 2016", "prism:doi"=>"10.1371/journal.pone.0161658", "citedby-count"=>"6", "affiliation"=>[{"@_fa"=>"true", "affilname"=>"University of Texas at Austin", "affiliation-city"=>"Austin", "affiliation-country"=>"United States"}, {"@_fa"=>"true", "affilname"=>"University of Texas Health Science Center at San Antonio", "affiliation-city"=>"San Antonio", "affiliation-country"=>"United States"}], "pubmed-id"=>"27556897", "prism:aggregationType"=>"Journal", "subtype"=>"ar", "subtypeDescription"=>"Article", "article-number"=>"e0161658", "source-id"=>"10600153309", "openaccess"=>"1", "openaccessFlag"=>true}

Twitter

Counter

  • {"month"=>"8", "year"=>"2016", "pdf_views"=>"107", "xml_views"=>"0", "html_views"=>"822"}
  • {"month"=>"9", "year"=>"2016", "pdf_views"=>"97", "xml_views"=>"0", "html_views"=>"350"}
  • {"month"=>"10", "year"=>"2016", "pdf_views"=>"23", "xml_views"=>"0", "html_views"=>"87"}
  • {"month"=>"11", "year"=>"2016", "pdf_views"=>"7", "xml_views"=>"0", "html_views"=>"63"}
  • {"month"=>"12", "year"=>"2016", "pdf_views"=>"17", "xml_views"=>"0", "html_views"=>"45"}
  • {"month"=>"1", "year"=>"2017", "pdf_views"=>"7", "xml_views"=>"0", "html_views"=>"35"}
  • {"month"=>"2", "year"=>"2017", "pdf_views"=>"26", "xml_views"=>"0", "html_views"=>"51"}
  • {"month"=>"3", "year"=>"2017", "pdf_views"=>"8", "xml_views"=>"3", "html_views"=>"43"}
  • {"month"=>"4", "year"=>"2017", "pdf_views"=>"8", "xml_views"=>"1", "html_views"=>"50"}
  • {"month"=>"5", "year"=>"2017", "pdf_views"=>"19", "xml_views"=>"0", "html_views"=>"41"}
  • {"month"=>"6", "year"=>"2017", "pdf_views"=>"8", "xml_views"=>"1", "html_views"=>"33"}
  • {"month"=>"7", "year"=>"2017", "pdf_views"=>"12", "xml_views"=>"0", "html_views"=>"39"}
  • {"month"=>"8", "year"=>"2017", "pdf_views"=>"10", "xml_views"=>"2", "html_views"=>"32"}
  • {"month"=>"9", "year"=>"2017", "pdf_views"=>"4", "xml_views"=>"1", "html_views"=>"26"}
  • {"month"=>"10", "year"=>"2017", "pdf_views"=>"4", "xml_views"=>"1", "html_views"=>"46"}
  • {"month"=>"11", "year"=>"2017", "pdf_views"=>"10", "xml_views"=>"0", "html_views"=>"144"}
  • {"month"=>"12", "year"=>"2017", "pdf_views"=>"7", "xml_views"=>"1", "html_views"=>"184"}
  • {"month"=>"1", "year"=>"2018", "pdf_views"=>"7", "xml_views"=>"0", "html_views"=>"28"}
  • {"month"=>"2", "year"=>"2018", "pdf_views"=>"13", "xml_views"=>"0", "html_views"=>"30"}
  • {"month"=>"3", "year"=>"2018", "pdf_views"=>"7", "xml_views"=>"0", "html_views"=>"15"}
  • {"month"=>"4", "year"=>"2018", "pdf_views"=>"13", "xml_views"=>"0", "html_views"=>"20"}
  • {"month"=>"5", "year"=>"2018", "pdf_views"=>"5", "xml_views"=>"1", "html_views"=>"30"}
  • {"month"=>"6", "year"=>"2018", "pdf_views"=>"10", "xml_views"=>"0", "html_views"=>"28"}
  • {"month"=>"7", "year"=>"2018", "pdf_views"=>"7", "xml_views"=>"3", "html_views"=>"25"}
  • {"month"=>"8", "year"=>"2018", "pdf_views"=>"8", "xml_views"=>"0", "html_views"=>"18"}

PMC Usage Stats

  • {"unique-ip"=>"21", "full-text"=>"24", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"9"}
  • {"unique-ip"=>"49", "full-text"=>"58", "pdf"=>"27", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"10"}
  • {"unique-ip"=>"32", "full-text"=>"39", "pdf"=>"16", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"11"}
  • {"unique-ip"=>"18", "full-text"=>"19", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"12"}
  • {"unique-ip"=>"21", "full-text"=>"19", "pdf"=>"12", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"1"}
  • {"unique-ip"=>"23", "full-text"=>"29", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"2"}
  • {"unique-ip"=>"24", "full-text"=>"31", "pdf"=>"13", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"3"}
  • {"unique-ip"=>"12", "full-text"=>"12", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"4"}
  • {"unique-ip"=>"27", "full-text"=>"26", "pdf"=>"13", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"5"}
  • {"unique-ip"=>"12", "full-text"=>"13", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"6"}
  • {"unique-ip"=>"22", "full-text"=>"24", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2017", "month"=>"7"}
  • {"unique-ip"=>"17", "full-text"=>"17", "pdf"=>"19", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"8"}
  • {"unique-ip"=>"39", "full-text"=>"38", "pdf"=>"16", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"9"}
  • {"unique-ip"=>"36", "full-text"=>"39", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"10"}
  • {"unique-ip"=>"42", "full-text"=>"46", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"11"}
  • {"unique-ip"=>"18", "full-text"=>"21", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"12"}
  • {"unique-ip"=>"31", "full-text"=>"40", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"1"}
  • {"unique-ip"=>"4", "full-text"=>"4", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"2"}
  • {"unique-ip"=>"38", "full-text"=>"41", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"3"}
Loading … Spinner
There are currently no alerts