Volume 9, Number 11—November 2003
Research
Fluoroquinolones and the Risk for Methicillin-resistant Staphylococcus aureus in Hospitalized Patients1
Stephen G. Weber*
, Howard S. Gold*, David C. Hooper†, A.W. Karchmer*, and Yehuda Carmeli*
, Howard S. Gold*, David C. Hooper†, A.W. Karchmer*, and Yehuda Carmeli*Table 1
Results of univariate analysis for MRSA casesa
| Risk factor |
Uncolonized (n = 343) |
MRSA cases (n = 222) |
|||||
|---|---|---|---|---|---|---|---|
| no. |
% |
no. |
% |
OR (95% CI) |
p value |
||
| Demographic | |||||||
| Male |
137 |
39.9 |
126 |
56.8 |
1.84 (1.27 to 2.67) |
0.001 |
|
| Age |
mean = 57.6 y |
mean = 66.2 y |
<0.001 |
||||
| <50 |
131 |
38.2 |
39 |
17.6 |
— |
— |
|
| 51–75 |
137 |
39.9 |
110 |
49.5 |
2.39 (1.50 to 3.83) |
<0.001 |
|
| >75 |
75 |
21.9 |
73 |
32.9 |
2.86 (1.70 to 4.79) |
<0.001 |
|
| Coexisting condition |
|||||||
| Cardiovascular disease |
186 |
54.2 |
156 |
70.3 |
1.77 (1.20 to 2.31) |
0.004 |
|
| Lung disease |
57 |
16.6 |
130 |
58.6 |
6.74 (4.43 to 10.26) |
<0.001 |
|
| Renal disease |
30 |
8.7 |
46 |
20.7 |
2.02 (1.17 to 3.47) |
0.01 |
|
| Hepatic disease |
17 |
5.0 |
28 |
12.6 |
2.43 (1.23 to 4.79) |
0.01 |
|
| Organ transplant |
4 |
1.2 |
2 |
0.9 |
0.52 (0.08 to 3.36) |
0.49 |
|
| AIDS |
5 |
1.5 |
4 |
1.8 |
1.25 (0.30 to 5.14) |
0.76 |
|
| Malignancy |
54 |
15.7 |
32 |
14.4 |
0.98 (0.59 to 1.64) |
0.94 |
|
| Diabetes mellitus |
67 |
19.5 |
56 |
25.2 |
1.26 (0.81 to 1.96) |
0.31 |
|
| Hospital factors |
|||||||
| Transfer |
32 |
9.3 |
53 |
23.9 |
2.88 (1.71 to 4.83) |
<0.001 |
|
| Surgical procedure |
148 |
43.1 |
96 |
43.2 |
0.74 (0.51 to 1.09) |
0.12 |
|
| ICU stay |
54 |
15.7 |
144 |
64.9 |
7.66 (5.01 to 11.71) |
<0.001 |
|
| Intravenous line |
59 |
17.2 |
80 |
36.0 |
2.06 (1.38 to 3.16) |
<0.001 |
|
| Emergent admission |
149 |
43.4 |
136 |
61.3 |
2.20 (1.51 to 3.21) |
<0.001 |
|
| Admission service |
|||||||
| Medical |
174 |
50.7 |
154 |
69.4 |
— |
— |
|
| Obstetrical |
62 |
18.1 |
2 |
0.9 |
0.05 (0.01 to 0.21) |
<0.001 |
|
| Surgical |
107 |
31.2 |
66 |
29.7 |
0.74 (0.49 to 1.10) |
0.14 |
|
| Antimicrobial drugs |
|||||||
| Any fluoroquinolone |
72 |
21.0 |
150 |
67.6 |
5.41 (3.60 to 8.11) |
<0.001 |
|
| Levofloxacin |
42 |
12.2 |
109 |
49.1 |
5.36 (3.45 to 8.32) |
<0.001 |
|
| Ciprofloxacin |
34 |
9.9 |
62 |
27.9 |
2.16 (1.31 to 3.56) |
0.002 |
|
| Vancomycin |
36 |
10.5 |
94 |
42.3 |
3.98 (2.49 to 6.34) |
<0.001 |
|
| Penicillin |
36 |
10.5 |
56 |
25.2 |
2.08 (1.26 to 3.45) |
0.004 |
|
| β-lactam and inhibitor |
5 |
1.5 |
13 |
5.9 |
2.74 (0.88 to 8.46) |
0.08 |
|
| First-generation cephalosporin |
77 |
22.4 |
45 |
20.3 |
0.77 (0.49 to 1.21) |
0.25 |
|
| Third-generation cephalosporin |
28 |
8.2 |
74 |
33.3 |
3.66 (2.18 to 6.13) |
<0.001 |
|
| Carbapenem |
3 |
0.9 |
7 |
3.2 |
1.63 (0.37 to 7.10) |
0.52 |
|
| Clindamycin |
9 |
2.6 |
32 |
14.4 |
5.36 (2.39 to 12.01) |
<0.001 |
|
| Metronidazole | 42 | 12.2 | 104 | 46.8 | 4.20 (2.70 to 6.55) | <0.001 | |
aAll results adjusted for time at risk. MRSA, methicillin-resistant Staphylococcus aureus; OR, odds ratio; CI, confidence interval; ICU, intensive care unit.
