A Risk-Scoring System for Predicting Methicillin Resistance in Community-Onset Staphylococcus aureus Bacteremia in Korea

作者：Suh Hyeon Jeong; Park Wan Beom; Jung Sook In; Song Kyoung Ho; Kwak Yee Gyung; Kim Kye Hyung; Hwang Jeong Hwan; Yun Na Ra; Jang Hee Chang; Kim Young Keun; Kim Nak Hyun; Park Kyung Hwa; Kang Seung Ji; Lee Shinwon; Kim Eu Suk^*; Kim Hong Bin

来源：Microbial Drug Resistance, 2018, 24(5): 556-562.

DOI：10.1089/mdr.2017.0236

• Staphylococcus aureus
• methicillin-resistant
• bacteremia
• community-onset
• risk-scoring system

Aims: We aimed to develop a simple scoring system to predict risk for methicillin resistance in community-onset Staphylococcus aureus bacteremia (CO-SAB) by identifying the clinical and epidemiological risk factors for community-onset methicillin-resistant S. aureus (MRSA). Methods: We retrospectively analyzed data from three multicenter cohort studies in Korea in which patient information was prospectively collected and risk factors for methicillin resistance in CO-SAB were identified. We then developed and validated a risk-scoring system. Results: To analyze the 1,802 cases of CO-SAB, we included the four most powerful predictors of methicillin resistance that we identified in the scoring system: underlying hematologic disease (-1 point), endovascular infection as the primary site of infection (-1 point), history of hospitalization or surgery in 1 year (+0.5 points), and previous isolation of MRSA in 6 months (+1.5 points). With this scoring system, cases were classified into low (less than -0.5), intermediate (-0.5-1.5), and high (1.5) risk groups. The proportions of MRSA cases in each group were 24.7% (22/89), 39.0% (607/1,557), and 78.8% (123/156), respectively, and 16.7% (1/6), 33.8% (112/331), and 76.9% (10/13) in a validation set. Conclusions: This risk-scoring system for methicillin resistance in CO-SAB may help physicians select appropriate empirical antibiotics more quickly.

• 出版日期2018-6