68 Chapter 4 In univariate analysis, Odds ratio’s (with 95% confidence intervals) and Fisher’s exact tests were applied to identify clinical risk factors of treatment failure. In the multivariable regression analyses variables from univariate analysis with a p<0.05 were included, together with variables that were previously reported to be associated with treatment failure: MRSA throat carriage and perineal carriage [20, 21]. Ethical approval Ethical approval was granted by the institutional ethical review committee of the Leiden University Medical Center and the participating hospitals. Results During the study period, 224 patients were referred to the outpatient departments because of MRSA colonization. Because of absence of colonization or uncomplicated carriership at the first evaluation, respectively 27 and 20 patients were excluded. Of the remaining 177 patients, only 131 received systemic antibiotics (Figure 1). Reasons for not starting decolonization with systemic antibiotics were spontaneous clearance of colonization (14/177; 8%), lost to follow up (6/177; 3%) and/or acceptance of colonization (23/177; 13%). Reasons for accepting colonization were either related to a high risk of failure, i.e. therapy resistant skin lesions in eczema, or to a high risk of recurrence, i.e. frequent livestock contact or regular visits to health care facilities abroad. Three patients (3/177; 2%) were successfully treated with topical therapy only. The patient characteristics of all 177 patients with complicated colonization and of the 131 patients with complicated colonization that were treated with systemic antibiotic therapy are summarized in Table 2. Of the 131 patients with complicated colonization and treatment with systemic antibiotics, 19 (15%) lived alone, 103 (79%) lived with one or more household members and in 9 patients (7%) data on household members were missing. In 91/103 (88%) patients all household members were screened for carriership. In 5/103 (5%) only part of the household members were screened and in 7/103 (7%) none of the household members were screened. In total, 229 household members were screened, of which 91 (40%) tested positive for MRSA.
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