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- Title
Duration of Colonization and Determinants of Earlier Clearance of Colonization With Methicillin-Resistant Staphylococcus aureus.
- Authors
Cluzet, Valerie C.; Gerber, Jeffrey S.; Nachamkin, Irving; Metlay, Joshua P.; Zaoutis, Theoklis E.; Davis, Meghan F.; Julian, Kathleen G.; Royer, David; Linkin, Darren R.; Coffin, Susan E.; Margolis, David J.; Hollander, Judd E.; Mistry, Rakesh D.; Gavin, Laurence J.; Tolomeo, Pam; Wise, Jacqueleen A.; Wheeler, Mary K.; Bilker, Warren B.; Xiaoyan Han; Baofeng Hu
- Abstract
Background. The duration of colonization and factors associated with clearance of methicillin-resistant Staphylococcus aureus (MRSA) after community-onset MRSA skin and soft-tissue infection (SSTI) remain unclear. Methods. We conducted a prospective cohort study of patients with acute MRSA SSTI presenting to 5 adult and pediatric academic hospitals from 1 January 2010 through 31 December 2012. Index patients and household members performed self-sampling for MRSA colonization every 2 weeks for 6 months. Clearance of colonization was defined as negative MRSA surveillance cultures during 2 consecutive sampling periods. A Cox proportional hazards regression model was developed to identify determinants of clearance of colonization. Results. Two hundred forty-three index patients were included. The median duration of MRSA colonization after SSTI diagnosis was 21 days (95% confidence interval [CI], 19-24), and 19.8% never cleared colonization. Treatment of the SSTI with clindamycin was associated with earlier clearance (hazard ratio [HR], 1.72; 95% CI, 1.28-2.30; P < .001). Older age (HR, 0.99; 95% CI, .98-1.00; P = .01) was associated with longer duration of colonization. There was a borderline significant association between increased number of household members colonized with MRSA and later clearance of colonization in the index patient (HR, 0.85; 95% CI, .71-1.01; P = .06). Conclusions. With a systematic, regular sampling protocol, duration of MRSA colonization was noted to be shorter than previously reported, although 19.8% of patients remained colonized at 6 months. The association between clindamycin and shorter duration of colonization after MRSA SSTI suggests a possible role for the antibiotic selected for treatment of MRSA infection.
- Subjects
METHICILLIN-resistant staphylococcus aureus; BACTERIAL colonies; CHILDREN'S hospitals; SOFT tissue infections; PROPORTIONAL hazards models
- Publication
Clinical Infectious Diseases, 2015, Vol 60, Issue 10, p1489
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/civ075