Major articleRisk factors and mortality in patients with nosocomial Staphylococcus aureus bacteremia
Section snippets
Hospital and patients
From 1990 to 2004, a retrospective cohort study was performed to determine and compare mortality of nosocomial MRSA and MSSA bacteremia. The study took place in a 2900-bed tertiary referral medical center. Each episode of nosocomial infection was defined as one that had at least one S aureus–positive blood culture at least 48 hours after admission according to standard definitions proposed by the Centers for Disease Control and Prevention. Only the first S aureus bacteremia was recorded for
Results
During the 15-year study period, a total of 1148 patients were diagnosed with nosocomial S aureus bacteremia. Of these, 506 patients died during the course of treatment, representing a crude mortality rate of 44.1%. Of the diagnosed patients, 851 (74.1%) presented with MRSA bacteremia with a crude mortality rate of 49.8% (424/851), and 297 patients (25.9%) presented with MSSA bacteremia with a crude mortality rate of 27.6% (82/297). The rate difference of mortality was 22.2% with statistical
Discussion
Methicillin resistance in Staphylococcus was first reported in 1961. Since then, methicillin-resistant Staphylococcus had become a significant problem in medical facilities worldwide, with MRSA now accounting for 40%-86% of nosocomial S aureus bacteremia.5, 9, 10, 11 Confirming this clinical significance, the present 15-year study involving 1148 patients documented that MRSA accounted for 74.1% of all nosocomial S aureus bacteremia in a large tertiary care hospital.
Risk factors for acquiring
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None of the authors has any commercial or other association that might pose a conflict of interest.
This study was supported by a research grant from Taipei Veterans General Hospital, Taipei, Taiwan.