Reevaluation of the impact of methicillin-resistance on outcomes in patients with Staphylococcus aureus bacteremia and endocarditisopen access
- Authors
- Joo, EJ[Joo, Eun-Jeong]; Park, DA[Park, Dong Ah]; Kang, CI[Kang, Cheol-In]; Chung, DR[Chung, Doo Ryeon]; Song, JH[Song, Jae-Hoon]; Lee, SM[Lee, Sang Moo]; Peck, KR[Peck, Kyong Ran]
- Issue Date
- Nov-2019
- Publisher
- KOREAN ASSOC INTERNAL MEDICINE
- Keywords
- Methicillin resistance; Staphylococcus aureus; Bacteremia; Endocarditis; Mortality
- Citation
- KOREAN JOURNAL OF INTERNAL MEDICINE, v.34, no.6, pp.1347 - +
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- KOREAN JOURNAL OF INTERNAL MEDICINE
- Volume
- 34
- Number
- 6
- Start Page
- 1347
- End Page
- +
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/8292
- DOI
- 10.3904/kjim.2017.098
- ISSN
- 1226-3303
- Abstract
- Background/Aims: Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in hospitals, and has recently emerged in the community. The impact of methicillin-resistance on mortality and medical costs for patients with S. aureus bacteremia (SAB) requires reevaluation. Methods: We searched studies with SAB or endocarditis using electronic databases including Ovid-Medline, Embase-Medline, and Cochrane Library, as well as five local databases for published studies during the period January 2000 to September 2011. Results: A total of 2,841 studies were identified, 62 of which involved 17,563 adult subjects and were selected as eligible. A significant increase in overall mortality associated with MRSA, compared to that with methicillin-susceptible S. aureus (MSSA), was evidenced by an odds ratio (OR) of 1.95 (95% confidence interval [CI], 1.73 to 2.21; p < 0.01). In 13 endocarditis studies, MRSA increased the risk of mortality, with an OR of 2.65 (95% CI, 1.46 to 4.80). When three studies, which compared mortality rates between CA-MRSA and CA-MSSA, were combined, the risk of methicillin-resistance increased 3.23-fold compared to MSSA (95% CI, 1.25 to 8.34). The length of hospital stay in the MRSA group was 10 days longer than that in the MSSA group (95% CI, 3.36 to 16.70). Of six studies that reported medical costs, two were included in the analysis, which estimated medical costs to be $9,954.58 (95% CI, 8,951.99 to 10,957.17). Conclusions: MRSA is still associated with increased mortality, longer hospital stays and medical costs, compared with MSSA in SAB in studies published since the year 2000.
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