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

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

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Abstract

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.

Original languageEnglish
Pages (from-to)556-562
Number of pages7
JournalMicrobial Drug Resistance
Volume24
Issue number5
DOIs
Publication statusPublished - 2018 Jun

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Methicillin Resistance
Korea
Bacteremia
Staphylococcus aureus
Methicillin-Resistant Staphylococcus aureus
Hematologic Diseases
Infection
Multicenter Studies
Hospitalization
Cohort Studies
Anti-Bacterial Agents
Physicians

All Science Journal Classification (ASJC) codes

  • Microbiology
  • Immunology
  • Pharmacology
  • Microbiology (medical)

Cite this

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. / A Risk-Scoring System for Predicting Methicillin Resistance in Community-Onset Staphylococcus aureus Bacteremia in Korea. In: Microbial Drug Resistance. 2018 ; Vol. 24, No. 5. pp. 556-562.
@article{c43a52c304274332a6faf05ba6a2411b,
title = "A Risk-Scoring System for Predicting Methicillin Resistance in Community-Onset Staphylococcus aureus Bacteremia in Korea",
abstract = "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.",
author = "Suh, {Hyeon Jeong} and Park, {Wan Beom} and Jung, {Sook In} and Song, {Kyoung Ho} and Kwak, {Yee Gyung} and Kim, {Kye Hyung} and Hwang, {Jeong Hwan} and Yun, {Na Ra} and Jang, {Hee Chang} and Kim, {Young Keun} and Kim, {Nak Hyun} and Park, {Kyung Hwa} and Kang, {Seung Ji} and Shinwon Lee and Kim, {Eu Suk} and Kim, {Hong Bin}",
year = "2018",
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Suh, HJ, Park, WB, Jung, SI, Song, KH, Kwak, YG, Kim, KH, Hwang, JH, Yun, NR, Jang, HC, Kim, YK, Kim, NH, Park, KH, Kang, SJ, Lee, S, Kim, ES & Kim, HB 2018, 'A Risk-Scoring System for Predicting Methicillin Resistance in Community-Onset Staphylococcus aureus Bacteremia in Korea', Microbial Drug Resistance, vol. 24, no. 5, pp. 556-562. https://doi.org/10.1089/mdr.2017.0236

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

In: Microbial Drug Resistance, Vol. 24, No. 5, 06.2018, p. 556-562.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A Risk-Scoring System for Predicting Methicillin Resistance in Community-Onset Staphylococcus aureus Bacteremia in Korea

AU - Suh, Hyeon Jeong

AU - Park, Wan Beom

AU - Jung, Sook In

AU - Song, Kyoung Ho

AU - Kwak, Yee Gyung

AU - Kim, Kye Hyung

AU - Hwang, Jeong Hwan

AU - Yun, Na Ra

AU - Jang, Hee Chang

AU - Kim, Young Keun

AU - Kim, Nak Hyun

AU - Park, Kyung Hwa

AU - Kang, Seung Ji

AU - Lee, Shinwon

AU - Kim, Eu Suk

AU - Kim, Hong Bin

PY - 2018/6

Y1 - 2018/6

N2 - 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.

AB - 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.

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DO - 10.1089/mdr.2017.0236

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VL - 24

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JO - Microbial Drug Resistance

JF - Microbial Drug Resistance

SN - 1076-6294

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