Community-associated versus healthcare-associated methicillin-resistant Staphylococcus aureus bacteraemia: a 10-year retrospective review

  • J. O. Robinson
  • J. C. Pearson
  • K. J. Christiansen
  • G. W. Coombs
  • R. J. Murray
Article

Abstract

The objective was to compare the epidemiology and outcome of healthcare- (HA-) and community-associated (CA-) MRSA bacteraemia. A 10-year retrospective study of MRSA bacteraemia was carried out. Episodes were classified according to established criteria. Molecular typing was performed on a subset of isolates. Of 197 MRSA bacteraemia episodes, 178 (90.4%) were classified as HA-MRSA and 19 (9.6%) as CA-MRSA. All-cause 7- and 30-day mortality rates were similar in the HA and CA-MRSA bacteraemia groups; however, 1-year mortality was higher in the HA-MRSA bacteraemia group (48.3% vs 21.1% [p = 0.023]). Thirty-day all-cause mortality was significantly lower if empiric antimicrobial therapy included agent(s) to which the isolate tested susceptible, compared with patients receiving “inactive” therapy (19% vs 35.1% [p = 0.011]). The majority of MRSA bacteraemia episodes were caused by clones known to circulate in the community. All-cause mortality is as high in HA- as in CA-MRSA bacteraemia. Thirty-day mortality was significantly reduced if the patient received an antibiotic with activity against the MRSA isolate.

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • J. O. Robinson
    • 1
  • J. C. Pearson
    • 1
  • K. J. Christiansen
    • 1
    • 2
  • G. W. Coombs
    • 1
    • 2
  • R. J. Murray
    • 1
  1. 1.Department of Microbiology and Infectious DiseasesPathWest Laboratory Medicine, Royal Perth HospitalPerthWestern Australia
  2. 2.Gram-positive Bacteria Typing and Research Unit, School of Biomedical SciencesCurtin University of TechnologyPerthWestern Australia

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