This article is more than 5 years old. Information may no longer be current.
Fluoroquinolone use increased risk for MRSA in long-term care
The use of fluoroquinolones was a risk factor for MRSA acquisition among patients in long-term care facilities, researchers from Institut Pasteur in Paris have found.
“The association between fluoroquinolone use and MRSA acquisition we found expands previous knowledge on risk factors for MRSA colonization/infection in tertiary care hospitals, [reinforcing] that antibiotic stewardship is essential whatever the setting,” the researchers wrote in Clinical Infectious Diseases.
The researchers conducted a prospective study that included 451 patients who were not colonized with Staphylococcus aureus upon admission to a long-term care facility for neurologic impairment. Each patient was evaluated weekly for nasal colonization status and potential risk factors. The researchers then conducted case-control analyses for patients who acquired MRSA or methicillin-sensitive S. aureus (MSSA).
During the follow-up period, 187 patients had at least one positive nasal swab: 76 patients developed MRSA and 112 patients developed MSSA (one patient developed both). Among the 188 isolates, 71 (93.4%) of the MRSA strains and eight (7.1%) of the MSSA strains were resistant to fluoroquinolones.
In the case-control analyses, the 76 MRSA cases were matched to 207 controls, and the 112 MSSA cases were matched to 208 MSSA controls. In a multivariable analysis, there were three factors associated with MRSA acquisition: Male gender (OR=2.09; 95% CI, 1.1-3.98); higher ICU burden at admission (OR=3.24; 95% CI, 1.74-6.04); and fluoroquinolone use (OR=2.17; 95% CI, 1.01-4.67). Factors associated with MSSA acquisition included the need for assistance with body-washing and the use of a urination device.
“S. aureus cross-contamination in [long-term care facilities] can be controlled by improving hygiene, particularly hand-washing,” the researchers wrote. “Notably, the fluoroquinolone impact on MRSA acquisition represents another determinant of MRSA diffusion.”
Disclosure: The researchers report no relevant financial disclosures.