Much ado about nothing: methicillin-resistant Staphylococcus aureus.
The pathogenic methicillin-resistant Staphylococcus aureus (MRSA) has received a voluminous amount of notoriety. The four major reasons are its morbidity, mortality rate, cost of treatment, and constant appearance in intensive care units. Both Staphylococcus aureus and S. epidermidis (MRSE) account for 82% of our gram-positive wound isolates, whereas the gram-negative account for 34% of all isolates. Therefore we compared the morbidity, mortality rate, and cost factors related to MRSA-MRSE and gram-negative infections for a 4-year period, assessing more than 214 documented infections. Morbidity and mortality rates were minor for MRSA. Pseudomonas aeruginosa and Escherichia coli accounted for 57.5% of the total gram-negative isolates. Gram-negative antimicrobial therapy usually requires two therapeutic drugs, which increases morbidity and costs, whereas the staphylococci usually can be treated by one antimicrobial. During this period there were 47 gram-negative infections requiring 10 to 15 additional days of hospital stay, with a daily antibiotic cost of $293.40. Costs for MRSA or MRSE are 28% less. Therefore our preoccupation with MRSA or MRSE infections is unwarranted and unsubstantiated.
Shannon
T
T
Department of Surgery, University of Texas Medical Branch, Galveston, USA.
Edgar
P
P
Villarreal
C
C
Herndon
D N
DN
Phillips
L G
LG
Heggers
J P
JP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics*; D002053:Burn Units / Q000191:economics* / Q000592:standards; D002056:Burns / Q000150:complications / Q000191:economics / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000191:economics* / Q000453:epidemiology / Q000401:mortality; D016527:Drug Costs / Q000706:statistics & numerical data; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D016106:Methicillin Resistance; D009017:Morbidity; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000191:economics* / Q000453:epidemiology / Q000401:mortality; D013211:Staphylococcus aureus / Q000187:drug effects*; D013212:Staphylococcus epidermidis / Q000187:drug effects; D013781:Texas / Q000453:epidemiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents