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Volume 9, Number 11—November 2003
Research

Fluoroquinolones and the Risk for Methicillin-resistant Staphylococcus aureus in Hospitalized Patients1

Stephen G. Weber*Comments to Author , Howard S. Gold*, David C. Hooper†, A.W. Karchmer*, and Yehuda Carmeli*
Author affiliations: *Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA; †Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA

Main Article

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.

Main Article

1This study was presented in part at the 42nd Interscience Conference on Antimicrobial Agents and Chemotherapy, Sand Diego, California, September 2002.

Page created: January 21, 2011
Page updated: January 21, 2011
Page reviewed: January 21, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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