Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Correlations between clinical, phenotypic, genotypic characteristics and mortality in a tertiary teaching hospital in Malaysia

Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is a serious infection that can result in significant morbidity and mortality. A retrospective cohort study was conducted to determine the predictors of mortality in patient with MRSA bacteremia correlating with clinical, phenotypic and g...

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Main Authors: Sit, Pik San, Teh, Cindy Shuan Ju, Idris, Nuryana, Ponnampalavanar, Sasheela
Format: Article
Published: Elsevier 2018
Subjects:
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author Sit, Pik San
Teh, Cindy Shuan Ju
Idris, Nuryana
Ponnampalavanar, Sasheela
author_facet Sit, Pik San
Teh, Cindy Shuan Ju
Idris, Nuryana
Ponnampalavanar, Sasheela
author_sort Sit, Pik San
collection UM
description Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is a serious infection that can result in significant morbidity and mortality. A retrospective cohort study was conducted to determine the predictors of mortality in patient with MRSA bacteremia correlating with clinical, phenotypic and genotypic characteristics of the relevant strains. Most of the bacteremia cases were healthcare-associated (P < 0.0001). Older age (P < 0.0001) and comorbidities (diabetes mellitus, hypertension and chronic kidney disease) were identified as the risk factors for MRSA bacteremia. All the strains were sensitive to vancomycin. Most MRSA strains causing bacteremia belonged to SCCmec type III-ST239 and exhibited pulsotype H. According to the multivariate analysis, age ≥ 60 years old (P = 0.022), female gender (P = 0.0003), pneumonia (P = 0.011) as source of infection as well as high APACHE II, Charlson comorbidity Index and Pitt's bacteremia scores were significantly associated with patient's mortality. There were emergence of MRSA clones such as SCCmec type I-ST152, SCCmec type V-ST45 and SCCmec type V-ST951 that was discovered for the first time in Malaysia. To our knowledge, this is the first study correlating the clinical, phenotypic and genotypic characteristics of patients with MRSA bacteremia as well as determining the risk factors for mortality in Malaysian hospital.
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spelling um.eprints-206452019-03-11T07:22:11Z http://eprints.um.edu.my/20645/ Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Correlations between clinical, phenotypic, genotypic characteristics and mortality in a tertiary teaching hospital in Malaysia Sit, Pik San Teh, Cindy Shuan Ju Idris, Nuryana Ponnampalavanar, Sasheela R Medicine Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is a serious infection that can result in significant morbidity and mortality. A retrospective cohort study was conducted to determine the predictors of mortality in patient with MRSA bacteremia correlating with clinical, phenotypic and genotypic characteristics of the relevant strains. Most of the bacteremia cases were healthcare-associated (P < 0.0001). Older age (P < 0.0001) and comorbidities (diabetes mellitus, hypertension and chronic kidney disease) were identified as the risk factors for MRSA bacteremia. All the strains were sensitive to vancomycin. Most MRSA strains causing bacteremia belonged to SCCmec type III-ST239 and exhibited pulsotype H. According to the multivariate analysis, age ≥ 60 years old (P = 0.022), female gender (P = 0.0003), pneumonia (P = 0.011) as source of infection as well as high APACHE II, Charlson comorbidity Index and Pitt's bacteremia scores were significantly associated with patient's mortality. There were emergence of MRSA clones such as SCCmec type I-ST152, SCCmec type V-ST45 and SCCmec type V-ST951 that was discovered for the first time in Malaysia. To our knowledge, this is the first study correlating the clinical, phenotypic and genotypic characteristics of patients with MRSA bacteremia as well as determining the risk factors for mortality in Malaysian hospital. Elsevier 2018 Article PeerReviewed Sit, Pik San and Teh, Cindy Shuan Ju and Idris, Nuryana and Ponnampalavanar, Sasheela (2018) Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Correlations between clinical, phenotypic, genotypic characteristics and mortality in a tertiary teaching hospital in Malaysia. Infection, Genetics and Evolution, 59. pp. 132-141. ISSN 1567-1348, DOI https://doi.org/10.1016/j.meegid.2018.01.031 <https://doi.org/10.1016/j.meegid.2018.01.031>. https://doi.org/10.1016/j.meegid.2018.01.031 doi:10.1016/j.meegid.2018.01.031
spellingShingle R Medicine
Sit, Pik San
Teh, Cindy Shuan Ju
Idris, Nuryana
Ponnampalavanar, Sasheela
Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Correlations between clinical, phenotypic, genotypic characteristics and mortality in a tertiary teaching hospital in Malaysia
title Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Correlations between clinical, phenotypic, genotypic characteristics and mortality in a tertiary teaching hospital in Malaysia
title_full Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Correlations between clinical, phenotypic, genotypic characteristics and mortality in a tertiary teaching hospital in Malaysia
title_fullStr Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Correlations between clinical, phenotypic, genotypic characteristics and mortality in a tertiary teaching hospital in Malaysia
title_full_unstemmed Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Correlations between clinical, phenotypic, genotypic characteristics and mortality in a tertiary teaching hospital in Malaysia
title_short Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Correlations between clinical, phenotypic, genotypic characteristics and mortality in a tertiary teaching hospital in Malaysia
title_sort methicillin resistant staphylococcus aureus mrsa bacteremia correlations between clinical phenotypic genotypic characteristics and mortality in a tertiary teaching hospital in malaysia
topic R Medicine
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