M Moreira1, E A Medeiros, A C Pignatari, S B Wey, D M Cardo. 1. Serviço de Controle e Prevenção de Infecção Hospitalar e Disciplina de Doenças Infecciosas e Parasitárias, Universidade Federal de São Paulo, SP.
Abstract
OBJECTIVES: To identify the attributed mortality rate of bloodstream hospital infection by Staphylococcus aureus resistant to methicillin (MRSA) and its effect on length of hospital stay. DESIGN: Case-control study. SETTING: Hospital São Paulo da Universidade Federal de São Paulo, a 660-bed, tertiary-care teaching hospital in São Paulo, Brazil. PATIENTS: Seventy one adults patients with hospital-acquired MRSA bacteremia diagnosed between January 1, 1991, and September 30, 1992, and 71 MRSA-free controls were matched by the following criteria: age, sex, underlying disease, surgical procedure, same risk time and admission date. RESULTS: The incidence of patients with hospital sepsis by MRSA accounted for 73.22% of the patients with hospital bloodstream infection by Staphylococcus aureus. The mortality rate of the cases was 56.33 (40/71) and 11.26 (8/71) of the controls. The attributable mortality rate was 45.07% (OR = 17.0; IC 95% = 3.58-202.26; p = 0.000001). The length of hospital stay median time was of 32.55 days for the cases and 29.75 for the controls (p = 0.32). CONCLUSION: A high level of sepsis by MRSA was observed in all the Staphylococcus aureus bacteremia. The bloodstream hospital infection by MRSA itself does provide a high level of mortality independently from the patients base disease, without however, increasing their hospital length of stay.
OBJECTIVES: To identify the attributed mortality rate of bloodstream hospital infection by Staphylococcus aureus resistant to methicillin (MRSA) and its effect on length of hospital stay. DESIGN: Case-control study. SETTING: Hospital São Paulo da Universidade Federal de São Paulo, a 660-bed, tertiary-care teaching hospital in São Paulo, Brazil. PATIENTS: Seventy one adults patients with hospital-acquired MRSAbacteremia diagnosed between January 1, 1991, and September 30, 1992, and 71 MRSA-free controls were matched by the following criteria: age, sex, underlying disease, surgical procedure, same risk time and admission date. RESULTS: The incidence of patients with hospital sepsis by MRSA accounted for 73.22% of the patients with hospital bloodstream infection by Staphylococcus aureus. The mortality rate of the cases was 56.33 (40/71) and 11.26 (8/71) of the controls. The attributable mortality rate was 45.07% (OR = 17.0; IC 95% = 3.58-202.26; p = 0.000001). The length of hospital stay median time was of 32.55 days for the cases and 29.75 for the controls (p = 0.32). CONCLUSION: A high level of sepsis by MRSA was observed in all the Staphylococcus aureus bacteremia. The bloodstream hospital infection by MRSA itself does provide a high level of mortality independently from the patients base disease, without however, increasing their hospital length of stay.
Authors: Alexandre R Marra; Michael B Edmond; Betty A Forbes; Richard P Wenzel; Gonzalo M L Bearman Journal: J Clin Microbiol Date: 2006-04 Impact factor: 5.948