Reevaluation of the impact of methicillin-resistance on outcomes in patients with Staphylococcus aureus bacteremia and endocarditis
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...
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| Format: | Article |
| Language: | English |
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The Korean Association of Internal Medicine
2019-11-01
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| Series: | The Korean Journal of Internal Medicine |
| Subjects: | |
| Online Access: | http://www.kjim.org/upload/pdf/kjim-2017-098.pdf |
| _version_ | 1819081029582848000 |
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| author | Eun-Jeong Joo Dong Ah Park Cheol-In Kang Doo Ryeon Chung Jae-Hoon Song Sang Moo Lee Kyong Ran Peck |
| author_facet | Eun-Jeong Joo Dong Ah Park Cheol-In Kang Doo Ryeon Chung Jae-Hoon Song Sang Moo Lee Kyong Ran Peck |
| author_sort | Eun-Jeong Joo |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-21T19:54:17Z |
| format | Article |
| id | doaj.art-e9f2ba2a7c474175863fa7107a80d8e8 |
| institution | Directory Open Access Journal |
| issn | 1226-3303 2005-6648 |
| language | English |
| last_indexed | 2024-12-21T19:54:17Z |
| publishDate | 2019-11-01 |
| publisher | The Korean Association of Internal Medicine |
| record_format | Article |
| series | The Korean Journal of Internal Medicine |
| spelling | doaj.art-e9f2ba2a7c474175863fa7107a80d8e82022-12-21T18:52:08ZengThe Korean Association of Internal MedicineThe Korean Journal of Internal Medicine1226-33032005-66482019-11-013461347136210.3904/kjim.2017.098170015Reevaluation of the impact of methicillin-resistance on outcomes in patients with Staphylococcus aureus bacteremia and endocarditisEun-Jeong Joo0Dong Ah Park1Cheol-In Kang2Doo Ryeon Chung3Jae-Hoon Song4Sang Moo Lee5Kyong Ran Peck6 Division of Infectious Diseases, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea Office of Health Technology Evaluation, National Evidence-based Healthcare Collaboration Agency, Seoul, Korea Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Office of Health Technology Evaluation, National Evidence-based Healthcare Collaboration Agency, Seoul, Korea Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaBackground/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.http://www.kjim.org/upload/pdf/kjim-2017-098.pdfmethicillin resistancestaphylococcus aureusbacteremiaendocarditismortality |
| spellingShingle | Eun-Jeong Joo Dong Ah Park Cheol-In Kang Doo Ryeon Chung Jae-Hoon Song Sang Moo Lee Kyong Ran Peck Reevaluation of the impact of methicillin-resistance on outcomes in patients with Staphylococcus aureus bacteremia and endocarditis The Korean Journal of Internal Medicine methicillin resistance staphylococcus aureus bacteremia endocarditis mortality |
| title | Reevaluation of the impact of methicillin-resistance on outcomes in patients with Staphylococcus aureus bacteremia and endocarditis |
| title_full | Reevaluation of the impact of methicillin-resistance on outcomes in patients with Staphylococcus aureus bacteremia and endocarditis |
| title_fullStr | Reevaluation of the impact of methicillin-resistance on outcomes in patients with Staphylococcus aureus bacteremia and endocarditis |
| title_full_unstemmed | Reevaluation of the impact of methicillin-resistance on outcomes in patients with Staphylococcus aureus bacteremia and endocarditis |
| title_short | Reevaluation of the impact of methicillin-resistance on outcomes in patients with Staphylococcus aureus bacteremia and endocarditis |
| title_sort | reevaluation of the impact of methicillin resistance on outcomes in patients with staphylococcus aureus bacteremia and endocarditis |
| topic | methicillin resistance staphylococcus aureus bacteremia endocarditis mortality |
| url | http://www.kjim.org/upload/pdf/kjim-2017-098.pdf |
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