کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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3359636 | 1591821 | 2011 | 4 صفحه PDF | دانلود رایگان |
The aim of this study was to determine the rifampicin (RIF) resistance rate of meticillin-resistant Staphylococcus aureus (MRSA) amongst patients with MRSA bacteraemia who have or have not been exposed to RIF-containing antituberculous (anti-TB) treatment. From 2000 to 2008, patients with MRSA bacteraemia and previous exposure to RIF-containing anti-TB therapy were selected. Patients matched for sex, age and time of culture of MRSA bacteraemia but without exposure to anti-TB therapy were selected as a control group. A total of 139 patients, comprising 49 with RIF exposure and 90 without RIF exposure, were analysed. The RIF resistance rate was higher in patients with previous RIF exposure (61.2% vs. 20.0%; P < 0.001). The minimum inhibitory concentration of RIF that inhibited 50% of MRSA isolates (MIC50) for the study group was also higher (128 mg/L vs. 0.015 mg/L; P < 0.001). The mortality rate was higher in the study group (59.2% vs. 41.1%; P = 0.041). MRSA isolates recovered from patients with current usage of a RIF-containing anti-TB regimen were more likely to be resistant to RIF (87.5% vs. 36%; P = 0.001), with higher MIC50 values (256 mg/L vs. 1 mg/L; P = 0.002), and resulted in a higher mortality rate than isolates from patients with remote usage of an anti-TB regimen (79.2% vs. 40%; P = 0.005). Multivariate analysis showed that current anti-TB drug usage was the only risk factor for RIF resistance [odds ratio (OR) = 7.457, 95% confidence interval (CI) 1.581–35.167] and mortality (OR = 7.201, 95% CI 1.583–32.766). Given the high rate of RIF resistance in patients with prior anti-TB treatment, RIF susceptibility testing should be performed before considering combination treatment of RIF in MRSA infection.
Journal: International Journal of Antimicrobial Agents - Volume 37, Issue 6, June 2011, Pages 550–553