Clinical and prognostic differences between methicillin-resistant and methicillin-susceptible Staphylococcus aureus infective endocarditis
Abstract Background S. aureus (SA) infective endocarditis (IE) has a very high mortality, attributed to the age and comorbidities of patients, inadequate or delayed antibiotic treatment, and methicillin resistance, among other causes. The main study objective was to analyze epidemiological and clini...
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doaj-b2299a0b8f0f4646a5b0da3c44819af52020-11-25T03:22:10ZengBMCBMC Infectious Diseases1471-23342020-02-0120111110.1186/s12879-020-4895-1Clinical and prognostic differences between methicillin-resistant and methicillin-susceptible Staphylococcus aureus infective endocarditisCarmen Hidalgo-Tenorio0Juan Gálvez1Francisco Javier Martínez-Marcos2Antonio Plata-Ciezar3Javier De La Torre-Lima4Luis Eduardo López-Cortés5Mariam Noureddine6José M. Reguera7David Vinuesa8Maria Victoria García9Guillermo Ojeda10Rafael Luque11José Manuel Lomas12Jose Antonio Lepe13Arístides de Alarcón14Department of Infectious Diseases, Hospital Universitario Virgen de las NievesInfectious Disease Service, Hospital Universitario Virgen de la MacarenaInfectious Disease Service, Hospital Juan Ramón JiménezInfectious Disease Service, Hospital Regional Universitario Carlos HayaInternal Medicine Service, Hospital Costa del SolInfectious Disease Service, Hospital Universitario Virgen de la MacarenaInternal Medicine Service, Hospital Costa del SolInfectious Disease Service, Hospital Regional Universitario Carlos HayaInfectious Disease Unit, Hospital Universitario San CecilioInfectious Disease Service, Hospital Universitario Virgen de la VictoriaInfectious Disease Service, Hospital Universitario Virgen de la VictoriaInfectious Disease Service, Hospital Universitario Virgen del RocíoInfectious Disease Service, Oxford University Hospitals NHS Foundation TrustInfectious Disease Service, Hospital Universitario Virgen del RocíoInfectious Disease Service, Hospital Universitario Virgen del RocíoAbstract Background S. aureus (SA) infective endocarditis (IE) has a very high mortality, attributed to the age and comorbidities of patients, inadequate or delayed antibiotic treatment, and methicillin resistance, among other causes. The main study objective was to analyze epidemiological and clinical differences between IE by methicillin-resistant versus methicillin-susceptible SA (MRSA vs. MSSA) and to examine prognostic factors for SA endocarditis, including methicillin resistance and vancomycin minimum inhibitory concentration (MIC) values > 1 μg/mL to MRSA. Methods Patients with SA endocarditis were consecutively and prospectively recruited from the Andalusia endocarditis cohort between 1984 and January 2017. Results We studied 437 patients with SA endocarditis, which was MRSA in 13.5% of cases. A greater likelihood of history of COPD (OR 3.19; 95% CI 1.41–7.23), invasive procedures, or recognized infection focus in the 3 months before IE onset (OR 2.9; 95% CI 1.14–7.65) and of diagnostic delay (OR 3.94; 95% CI 1.64–9.5) was observed in patients with MRSA versus MSSA endocarditis. The one-year mortality rate due to SA endocarditis was 44.3% and associated with decade of endocarditis onset (1985–1999) (OR 8.391; 95% CI (2.82–24.9); 2000–2009 (OR 6.4; 95% CI 2.92–14.06); active neoplasm (OR 6.63; 95% CI 1.7–25.5) and sepsis (OR 2.28; 95% CI 1.053–4.9). Methicillin resistance was not associated with higher IE-related mortality (49.7 vs. 43.1%; p = 0.32). Conclusion MRSA IE is associated with COPD, previous invasive procedure or recognized infection focus, and nosocomial or healthcare-related origin. Methicillin resistance does not appear to be a decisive prognostic factor for SA IE.http://link.springer.com/article/10.1186/s12879-020-4895-1EndocarditisStaphylococcus aureusVancomycinMethicillin resistance |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Carmen Hidalgo-Tenorio Juan Gálvez Francisco Javier Martínez-Marcos Antonio Plata-Ciezar Javier De La Torre-Lima Luis Eduardo López-Cortés Mariam Noureddine José M. Reguera David Vinuesa Maria Victoria García Guillermo Ojeda Rafael Luque José Manuel Lomas Jose Antonio Lepe Arístides de Alarcón |
spellingShingle |
Carmen Hidalgo-Tenorio Juan Gálvez Francisco Javier Martínez-Marcos Antonio Plata-Ciezar Javier De La Torre-Lima Luis Eduardo López-Cortés Mariam Noureddine José M. Reguera David Vinuesa Maria Victoria García Guillermo Ojeda Rafael Luque José Manuel Lomas Jose Antonio Lepe Arístides de Alarcón Clinical and prognostic differences between methicillin-resistant and methicillin-susceptible Staphylococcus aureus infective endocarditis BMC Infectious Diseases Endocarditis Staphylococcus aureus Vancomycin Methicillin resistance |
author_facet |
Carmen Hidalgo-Tenorio Juan Gálvez Francisco Javier Martínez-Marcos Antonio Plata-Ciezar Javier De La Torre-Lima Luis Eduardo López-Cortés Mariam Noureddine José M. Reguera David Vinuesa Maria Victoria García Guillermo Ojeda Rafael Luque José Manuel Lomas Jose Antonio Lepe Arístides de Alarcón |
author_sort |
Carmen Hidalgo-Tenorio |
title |
Clinical and prognostic differences between methicillin-resistant and methicillin-susceptible Staphylococcus aureus infective endocarditis |
title_short |
Clinical and prognostic differences between methicillin-resistant and methicillin-susceptible Staphylococcus aureus infective endocarditis |
title_full |
Clinical and prognostic differences between methicillin-resistant and methicillin-susceptible Staphylococcus aureus infective endocarditis |
title_fullStr |
Clinical and prognostic differences between methicillin-resistant and methicillin-susceptible Staphylococcus aureus infective endocarditis |
title_full_unstemmed |
Clinical and prognostic differences between methicillin-resistant and methicillin-susceptible Staphylococcus aureus infective endocarditis |
title_sort |
clinical and prognostic differences between methicillin-resistant and methicillin-susceptible staphylococcus aureus infective endocarditis |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2020-02-01 |
description |
Abstract Background S. aureus (SA) infective endocarditis (IE) has a very high mortality, attributed to the age and comorbidities of patients, inadequate or delayed antibiotic treatment, and methicillin resistance, among other causes. The main study objective was to analyze epidemiological and clinical differences between IE by methicillin-resistant versus methicillin-susceptible SA (MRSA vs. MSSA) and to examine prognostic factors for SA endocarditis, including methicillin resistance and vancomycin minimum inhibitory concentration (MIC) values > 1 μg/mL to MRSA. Methods Patients with SA endocarditis were consecutively and prospectively recruited from the Andalusia endocarditis cohort between 1984 and January 2017. Results We studied 437 patients with SA endocarditis, which was MRSA in 13.5% of cases. A greater likelihood of history of COPD (OR 3.19; 95% CI 1.41–7.23), invasive procedures, or recognized infection focus in the 3 months before IE onset (OR 2.9; 95% CI 1.14–7.65) and of diagnostic delay (OR 3.94; 95% CI 1.64–9.5) was observed in patients with MRSA versus MSSA endocarditis. The one-year mortality rate due to SA endocarditis was 44.3% and associated with decade of endocarditis onset (1985–1999) (OR 8.391; 95% CI (2.82–24.9); 2000–2009 (OR 6.4; 95% CI 2.92–14.06); active neoplasm (OR 6.63; 95% CI 1.7–25.5) and sepsis (OR 2.28; 95% CI 1.053–4.9). Methicillin resistance was not associated with higher IE-related mortality (49.7 vs. 43.1%; p = 0.32). Conclusion MRSA IE is associated with COPD, previous invasive procedure or recognized infection focus, and nosocomial or healthcare-related origin. Methicillin resistance does not appear to be a decisive prognostic factor for SA IE. |
topic |
Endocarditis Staphylococcus aureus Vancomycin Methicillin resistance |
url |
http://link.springer.com/article/10.1186/s12879-020-4895-1 |
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