Risk of death from methicillin-resistant Staphylococcus aureus bacteraemia: a meta-analysis.

OBJECTIVE: To estimate the risk of death from healthcare-associated (nosocomial) bacteraemia caused by methicillin-resistant Staphylococcus aureus (MRSA), and compare it with that of nosocomial bacteraemia caused by methicillin-sensitive S. aureus (MSSA), by meta-analysis of selected studies. DATA SOURCES: Medline, EMBASE, Current Contents and Cochrane Library were searched for the period January 1978 (or earliest date of the database, if later than 1978) to December 2000. STUDY SELECTION: Studies which compared mortality of nosocomial MRSA and MSSA bacteraemia. DATA SYNTHESIS: Nine studies were analysed. All but one found an increased relative risk (RR) of death from MRSA bacteraemia, with RR ranging from 0.89 to 4.94. Meta-analysis showed that patients with MRSA bacteraemia have an RR of death, compared with patients with MSSA bacteraemia, of 2.12 (95% CI, 1.76-2.57) using the fixed-effect method, and 2.03 (95% CI, 1.55-2.65) using the random-effect method.
CONCLUSION: MRSA bacteraemia is associated with a real increase in risk of death, further justifying ongoing MRSA surveillance and control in healthcare facilities.