title: Infective endocarditis caused by USA300 methicillin-resistant Staphylococcus aureus (MRSA).
abstract: We report seven cases of infective endocarditis caused by USA300 methicillin-resistant Staphylococcus aureus (MRSA) at an urban, tertiary care, academic institution. Five strains were community associated and two were healthcare associated. All patients were injection drug users. Staphylococcus aureus isolates were characterised as USA300-type MRSA using pulsed-field gel electrophoresis. Five cases were right-sided endocarditis and two cases were left-sided. The mean length of in-hospital antimicrobial therapy was 23 days and the mean length of total antibiotic therapy was 55 days. Complications included heart failure resulting in valve replacement in one patient as well as death in that patient. As USA300 strains of MRSA continue to increase in prevalence, clinicians must be aware of the increasing spectrum of illness in considering management and prevention strategies.
authors.affiliation: Henry Ford Health System, Detroit, MI, USA.
authors.forename: N Z
authors.initials: NZ
authors.lastname: Haque
authors.forename: S L
authors.initials: SL
authors.lastname: Davis
authors.forename: C L
authors.initials: CL
authors.lastname: Manierski
authors.forename: D
authors.initials: D
authors.lastname: Vager
authors.forename: S M
authors.initials: SM
authors.lastname: Donabedian
authors.forename: M B
authors.initials: MB
authors.lastname: Perri
authors.forename: R
authors.initials: R
authors.lastname: Sabbagh
authors.forename: F
authors.initials: F
authors.lastname: Cheema
authors.forename: M J
authors.initials: MJ
authors.lastname: Zervos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016000:Cluster Analysis; D017714:Community-Acquired Infections / Q000382:microbiology; D003428:Cross Infection / Q000382:microbiology; D016172:DNA Fingerprinting; D016521:Electrophoresis, Gel, Pulsed-Field; D004697:Endocarditis, Bacterial / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006760:Hospitalization; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D007902:Length of Stay; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification*; D015819:Substance Abuse, Intravenous / Q000150:complications
chemical_list: D000900:Anti-Bacterial Agents