Long-term outcomes following infection with meticillin-resistant or meticillin-susceptible Staphylococcus aureus.
Staphylococcus aureus (SA) is becoming increasingly resistant to antibiotics in hospitals and the community. Long-term outcomes following susceptible and resistant SA infection have not been studied. We performed a retrospective matched pair analysis of all patients with positive culture for meticillin-resistant SA (MRSA) or meticillin-susceptible SA (MSSA) from any site to assess the outcomes of infection. Data were collected for length of hospitalisation and in-hospital mortality, as well as longer-term outcomes including all-cause mortality, number of rehospitalisations and subsequent cultures for SA during the year following infection. Twelve months after their initial SA infection, 42% of patients were dead. There were no differences between the groups in short-term mortality, length of hospitalisation, number of subsequent hospitalisations and cultures for SA during the year following infection. Following discharge, however, MRSA infection was associated with higher mortality than MSSA at three months (32% vs 18% P=0.02), six months (42% vs 22% P=0.002) and 12 months (51% vs 32% P=0.005). In conclusion, SA infection is associated with a high one-year all-cause mortality. Most deaths occur after discharge. The likelihood of dying during the year following infection is higher for patients with MRSA infection than for those with MSSA infection.
Haessler
S
S
Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire, USA. sarah.haessler@bhs.org
Mackenzie
T
T
Kirkland
K B
KB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001431:Bacteriological Techniques; D003470:Culture Media; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008712:Methicillin / Q000494:pharmacology; D016106:Methicillin Resistance; D008875:Middle Aged; D011379:Prognosis; D013203:Staphylococcal Infections / Q000382:microbiology / Q000401:mortality*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification / Q000472:pathogenicity*; D013997:Time Factors
D000900:Anti-Bacterial Agents; D003470:Culture Media; D008712:Methicillin