Fluoroquinolones and risk for methicillin-resistant Staphylococcus aureus, Canada

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Louiselle LeBlanc1, Jacques Pépin, Krystel Toulouse

  • 1University of Sherbrooke, Sherbrooke, Quebec, Canada.

Emerging Infectious Diseases
|November 1, 2006
PubMed

Insights

Fluoroquinolones are linked to increased risks of healthcare-associated infections, including methicillin-resistant Staphylococcus aureus (MRSA) colonization and Clostridium difficile-associated disease (CDAD). This highlights the need for careful antimicrobial drug selection to mitigate these risks.

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Pharmacology

Background:

  • Antimicrobial drug use is a known risk factor for Clostridium difficile-associated disease (CDAD).
  • The role of specific antimicrobial classes in facilitating healthcare-associated methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection requires further investigation.
  • Understanding these associations is crucial for infection control and antimicrobial stewardship.

Purpose of the Study:

  • To determine the association between antimicrobial drug receipt and healthcare-associated MRSA colonization and infection.
  • To compare the impact of antimicrobial drugs on MRSA with their effects on methicillin-susceptible S. aureus infection and CDAD.
  • To inform antimicrobial prescribing practices in healthcare settings.

Main Methods:

  • Retrospective cohort study involving 7371 episodes of care in a Quebec hospital.
  • Data collection on patient risk factors, including antimicrobial drug receipt.
  • Cox regression analysis to calculate crude and adjusted hazard ratios (AHR).

Main Results:

  • Fluoroquinolones were identified as the predominant risk factor for CDAD during a Quebec epidemic.
  • Receipt of fluoroquinolones significantly increased the risk for MRSA colonization (AHR 2.57) and infection (AHR 2.49).
  • The effect of antimicrobial drugs on MRSA colonization and infection was comparable to their effect on CDAD.

Conclusions:

  • Antimicrobial drug selection, particularly fluoroquinolones, plays a significant role in facilitating MRSA colonization and infection.
  • The findings underscore the importance of considering the impact on both MRSA and CDAD when choosing antimicrobial agents.
  • Judicious use of antimicrobials is essential to prevent the emergence and spread of resistant pathogens and C. difficile.

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