L O Conterno1, S B Wey, A Castelo. 1. Infectious Diseases Division of Marilia Medical School, São Paulo, Brazil.
Abstract
OBJECTIVE: To analyze risk factors for, and the role of methicillin resistance in, mortality in Staphylococcus aureus bacteremia. DESIGN: Nested case-control study. SETTING: General teaching hospital with a high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) strains, in São Paulo, Brazil. PATIENTS: 136 patients over 14 years old with documented S aureus bacteremia. Those who died were compared with those who survived at least 14 days. RESULTS: Mortality within 14 days of bacteremia was 39% (53/136). Mean age was 47 years. Hospital-acquired bacteremia represented 86% (117/136) of episodes. In 26% (35/136), infection was related to an intravascular catheter and in 13% (17/136) to the respiratory tract. Septic shock occurred in 22% (30/136) of cases. MRSA was isolated in 66% (90/136). Multivariate analysis identified three variables that were significantly and independently associated with mortality: site of entry (lung, odds ratio [OR], 17.0; unknown, OR, 12.3; others, OR, 6.6); occurrence of shock (OR, 8.9), and resistance of S aureus to methicillin (OR, 4.2). CONCLUSION: Our study shows that S aureus bacteremia has a high mortality, especially when the lung is the source of infection and when shock develops; resistance to methicillin may be another risk factor for poor outcome.
OBJECTIVE: To analyze risk factors for, and the role of methicillin resistance in, mortality in Staphylococcus aureus bacteremia. DESIGN: Nested case-control study. SETTING: General teaching hospital with a high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) strains, in São Paulo, Brazil. PATIENTS: 136 patients over 14 years old with documented S aureus bacteremia. Those who died were compared with those who survived at least 14 days. RESULTS: Mortality within 14 days of bacteremia was 39% (53/136). Mean age was 47 years. Hospital-acquired bacteremia represented 86% (117/136) of episodes. In 26% (35/136), infection was related to an intravascular catheter and in 13% (17/136) to the respiratory tract. Septic shock occurred in 22% (30/136) of cases. MRSA was isolated in 66% (90/136). Multivariate analysis identified three variables that were significantly and independently associated with mortality: site of entry (lung, odds ratio [OR], 17.0; unknown, OR, 12.3; others, OR, 6.6); occurrence of shock (OR, 8.9), and resistance of S aureus to methicillin (OR, 4.2). CONCLUSION: Our study shows that S aureus bacteremia has a high mortality, especially when the lung is the source of infection and when shock develops; resistance to methicillin may be another risk factor for poor outcome.
Authors: Ram Venkatesh Anantha; Januvi Jegatheswaran; Daniel Luke Pepe; Fran Priestap; Johan Delport; S M Mansour Haeryfar; John K McCormick; Tina Mele Journal: CMAJ Open Date: 2014-10-01
Authors: J O Robinson; S Pozzi-Langhi; M Phillips; J C Pearson; K J Christiansen; G W Coombs; R J Murray Journal: Eur J Clin Microbiol Infect Dis Date: 2012-03-03 Impact factor: 3.267
Authors: T Mölkänen; A Rostila; E Ruotsalainen; M Alanne; M Perola; A Järvinen Journal: Eur J Clin Microbiol Infect Dis Date: 2010-06-16 Impact factor: 3.267