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Recurrent Staphylococcus aureus bacteremia: pulsed-field gel electrophoresis findings in 29 patients.

Abstract
To identify risk factors for relapse among 309 prospectively identified cases of Staphylococcus aureus bacteremia, patients with recurrent S. aureus bacteremia were identified, and pulsed-field gel electrophoresis (PFGE) was performed on isolates from both episodes. PFGE banding patterns from both isolates were identical in 23 patients, consistent with relapsed infection. Patients with PFGE-confirmed relapse were more likely by both univariate and multivariate analyses to have an indwelling foreign body (odds ratio [OR]=18.2, 95% confidence interval [CI]=7. 6-43.6; P<.001), to have received vancomycin therapy (OR=4.1, 95% CI=1.5-11.6; P=.008), or be hemodialysis-dependent (OR=4.1, 95% CI=1. 8-9.3; P=.002) than patients who did not develop recurrent bacteremia. These results suggest that recurrent episodes of S. aureus bacteremia are primarily relapses and are associated with an indwelling foreign body, receiving vancomycin therapy, and hemodialysis dependence.
AuthorsV G Fowler Jr, L K Kong, G R Corey, G S Gottlieb, R S McClelland, D J Sexton, D Gesty-Palmer, L J Harrell
JournalThe Journal of infectious diseases (J Infect Dis) Vol. 179 Issue 5 Pg. 1157-61 (May 1999) ISSN: 0022-1899 [Print] United States
PMID10191218 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)
Chemical References
  • DNA, Bacterial
Topics
  • Adult
  • Aged
  • Bacteremia (microbiology, prevention & control)
  • DNA, Bacterial (analysis)
  • Electrophoresis, Gel, Pulsed-Field
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Recurrence
  • Risk Factors
  • Staphylococcal Infections (microbiology, prevention & control)
  • Staphylococcus aureus (genetics, isolation & purification)

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