Outcome and Attributable Mortality in Critically Ill Patients With Bacteremia Involving Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus

Abstract

In critically ill patients, after accurate adjustment for disease severity and acute illness, we found MRSA bacteremia to have a higher attributable mortality than MSSA bacteremia.

Increased mortality associated with meticillin-resistant Staphylococcus aureus (MRSA) infection in the Intensive Care Unit: results from the EPIC II study

“…Similar findings were also reported by Blot et al [3] in a smaller number of critically ill patients with bacteraemia caused by S. aureus where acute renal failure, length of mechanical ventilation, age and meticillin resistance were independently associated with mortality. Owing to the transverse design of the current study, it was not possible to evaluate the relationship between MRSA infection and duration of mechanical ventilation.…”

“…MRSA rates are known to vary over time in individual units and hospitals, emphasising the importance of conducting regular surveillance at local, regional and national levels with updated information on MRSA infections [1][2][3][4]. The rate of meticillin resistance in the S. aureus isolates in this study was ca.…”

“…However, whether meticillin resistance increases mortality in patients with S. aureus infection remains controversial. Some investigations and meta-analyses have reported that meticillin resistance does increase the mortality risk [2][3][4][5][6][7], whereas others have been unable to demonstrate any difference in mortality between meticillin-resistant S. aureus (MRSA) and meticillin-sensitive S. aureus (MSSA) infections [8][9][10][11][12][13][14][15]. The conflicting results may be explained by differences in setting, sample size, case mix, strain virulence, minimum inhibitory concentration (MIC), antibiotic choice, antibiotic dosage and timing of appropriate antimicrobial therapy.…”

Epidemiology of Methicillin-Resistant Staphylococcus aureus Colonization in a Surgical Intensive Care Unit

“…[4][5][6] Infections caused by methicillin-resistant S. aureus (MRSA) have been associated with increased mortality and hospital costs, compared with methicillin-susceptible strains. [7][8][9] Unidentified MRSA carriers serve as a potential reservoir for transmission. 10 Active surveillance for MRSA, using screening cultures and aggressive contact precautions, has been shown to reduce MRSA transmission.…”

Volume 25: An Important Milestone Despite Continuing Infection Control Challenges

“…MRSA, an epidemiologically important pathogen that appears to be significantly more deadly than methicillin-susceptible strains [9][10][11] and now accounts for about half of all nosocomial S. aureus infections in NNIS System hospitals, has been at the center of the controversy for both of these issues. 7,8 Thompson and Wenzel found during 1981 that MRSA could be controlled at UVA using active surveillance cultures and isolation.…”