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Volume 16, Number 9—September 2010

CME ACTIVITY - Research

Illicit Drug Use and Risk for USA300 Methicillin-Resistant Staphylococcus aureus Infections with Bacteremia

Kristen M. KreiselComments to Author , J. Kristie Johnson, O. Colin Stine, Michelle D. Shardell, Eli N. Perencevich, Alan J. Lesse, Fred M. Gordin, Michael W. Climo, and Mary-Claire Roghmann
Author affiliations: Author affiliations: University of Maryland, Baltimore, Maryland, USA (K.M. Kreisel, J.K. Johnson, O.C. Stine, M.D. Shardell, E.N. Perencevich, M.-C. Roghmann); VA Maryland Health Care System, Baltimore (K.M. Kreisel, E.N. Perencevich, M.-C. Roghmann); VA Western New York Healthcare System, Buffalo, New York, USA (A.J. Lesse); University at Buffalo, Buffalo (A.J. Lesse); Washington DC VA Medical Center, Washington, DC, USA (F.M. Gordin); George Washington University, Washington (F.M. Gordin); Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA (M.W. Climo); Medical College of Virginia at Virginia Commonwealth University, Richmond (M.W. Climo)

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Table 4

Patient and infection characteristics for 300 veterans with Staphylococcus aureus bacteremia and association with USA300 MRSA at 4 Veterans Affairs medical centers, USA, 2004–2008*

Variable
USA300 MRSA bacteremia,† n = 67
Bacteremia due to all other S. aureus,† n = 233
p value‡
Patient characteristics
Age, y, mean ± SD 63 ± 12 69 ± 13 0.0004
Sex
M 65 (22) 230 (78) 0.31
F 2 (40) 3 (60)
Race
Black 34 (36) 61 (64) 0.0001
Other 33 (16) 172 (84)
Year of presentation§
Late 45 (27) 124 (73) 0.04
Early 22 (17) 109 (83)
Charlson score, mean ± SD 5.2 ± 3.6 4.6 ± 2.8 0.19
HIV infection
Yes 5 (31) 11 (69) 0.36
No 62 (22) 222 (78)
Illicit drug use
Yes 13 (59) 9 (41) <0.0001
No 54 (19) 224 (81)
History of colonization or infection with MRSA*
Yes 21 (26) 59 (74) 0.33
No 46 (21) 174 (79)
Hospitalized in year before infection
Yes 40 (21) 155 (79) 0.30
No 27 (26) 78 (74)
Surgery in year before infection
Yes 17 (16) 92 (84) 0.03
No 50 (26) 141 (74)
Residence in LTCF in year before infection
Yes 10 (29) 24 (71) 0.29
No 57 (21) 209 (79)
Renal failure in year before infection
Yes 42 (23) 144 (77) 0.90
No
25 (22)
89 (78)

Infection characteristics
Nosocomial infection
Yes 25 (15) 147 (85) 0.0002
No 42 (33) 86 (67)
Central line at time of infection
Yes 11 (13) 72 (87) 0.02
No 56 (26) 161 (74)
Permanent hardware at time of infection
Yes 20 (33) 68 (77) 0.92
No 48 (28) 126 (72)
Source of infection
Primary 19 (15) 107 (85) 0.01
Secondary 48 (28) 126 (72)
Infection complicated by endocarditis
Yes 9 (24) 29 (76) 0.83
No 57 (22) 201 (78)
Infection complicated by pneumonia
Yes 8 (18) 37 (82) 0.40
No 57 (23) 186 (77)

*MRSA, methicillin-resistant S. aureus, LTCF, long-term care facility.
†Values are no. (%) except as indicated.
‡Calculated by using Pearson χ2 or Fisher exact tests for categorical variables, Student t test or Wilcoxon signed-rank test for continuous variables.
§Year of presentation stratified into 2 periods: early (January 1, 2004–March 31, 2006) and late (April 1, 2006–June 30, 2008).

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