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{
    "pk": 12381,
    "title": "Epidemiology of Community-Onset Staphylococcus aureus Bacteremia",
    "subtitle": null,
    "abstract": "Introduction: \nStaphylococcus aureus\n bacteremia (SAB) is the second-most common cause of community-onset (CO) bacteremia. The incidence of methicillin-resistant \nS. aureus\n (MRSA) has recently decreased across much of the United States, and we seek to describe risk factors for COMRSA bacteremia, which will aid emergency providers in their choice of empiric antibiotics.\nMethods: \nThis is a retrospective cohort study of all patients with SAB at a 500-bed safety net hospital. The proportion of \nS. aureus\n isolates that were MRSA ranged from 32-35% during the study period. Variables of interest included age, comorbid medical conditions, microbiology results, antibioticadministration, duration of bacteremia, duration of hospital admission, suspected source of SAB, and Elixhauser comorbidity score. The primary outcome was to determine risk factors for CO-MRSA bacteremia as compared to methicillin-susceptible \nS. aureus\n (MSSA) bacteremia in patients admittedto the hospital through the emergency department.\nResults:\n We identified 135 consecutive patients with CO-SAB. In comparison to those with MSSA bacteremia, patients with MRSA bacteremia were younger (odds ratio [OR] 0.5, 95% confidence interval [CI], 0.4-0.7) with higher Elixhauser comorbidity scores (OR 1.4, 95% CI, 1.1-1.7). Additionally, these patients were more likely to have a history of MRSA infection or colonization (OR 8.9, 95% CI,2.7-29.7) and intravenous drug use (OR 2.4, 95% CI, 1.0-5.7).\nConclusion: \nSAB continues to be prevalent in our urban community with CO-MRSA accounting for almost one-third of SAB cases. Previous MRSA colonization was the strongest risk factor for current MRSA infection in this cohort of patients with CO-SAB.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Staphylococcus aureus"
        },
        {
            "word": "MRSA"
        },
        {
            "word": "bacteremia"
        }
    ],
    "section": "Infectious Disease",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/9cn3s37j",
    "frozenauthors": [
        {
            "first_name": "James",
            "middle_name": "Y.",
            "last_name": "Yarovoy",
            "name_suffix": "",
            "institution": "Upstate Medical University, Department of Emergency Medicine, Syracuse, New York",
            "department": "None"
        },
        {
            "first_name": "Andrew",
            "middle_name": "A.",
            "last_name": "Monte",
            "name_suffix": "",
            "institution": "University of Colorado, Department of Emergency Medicine, Denver, Colorado",
            "department": "None"
        },
        {
            "first_name": "Bryan",
            "middle_name": "C.",
            "last_name": "Knepper",
            "name_suffix": "",
            "institution": "Denver Health Medical Center, Department of Patient Safety and Quality, Denver, Colorado",
            "department": "None"
        },
        {
            "first_name": "Heather",
            "middle_name": "L.",
            "last_name": "Young",
            "name_suffix": "",
            "institution": "Denver Health Medical Center, University of Colorado, Department of Medicine, Denver,\nColorado",
            "department": "None"
        }
    ],
    "date_submitted": "2018-12-17T19:08:11Z",
    "date_accepted": "2018-12-17T19:08:11Z",
    "date_published": "2019-04-16T18:40:17Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/12381/galley/6588/download/"
        }
    ]
}