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Factors influencing the clinical outcome of methicillin-resistant Staphylococcus aureus bacteraemia

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Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia is associated with high mortality due to a combination of host, pathogen and therapy related factors. This was a retrospective exploratory study to evaluate host, pathogen and therapy related factors influencing the clinical outcome of MRSA bacteraemia in a UK teaching hospital setting. Of the 38 consecutive episodes of MRSA bacteraemia over a 1-year period, 16 of 38 (40%) patients died at 1 month and 21/38 (55%) died at 6 months. Univariate analysis revealed age (p < 0.006), mean serum vancomycin level (p < 0.035), agr group I (p < 0.036) and set4-var2_11 gene (p < 0.036) at 1 month; and age (p < 0.004) and set4-var2_11 gene (p < 0.002) at 6 months as significant factors. However, there was no association between first trough vancomycin concentration and outcome at 1 month. Multivariate survival analysis from time of admission showed, for each one year increase in age, a patient is 1.121 (95% CI 1.006–1.250, p < 0.007) times more likely to die at any particular point in time, and patients with a mean serum vancomycin level of <10 mg/L, the odds ratio of adverse outcome is 16.129 (95% CI 2.398–111.111) compared to patients with a mean serum level >10 mg/L. A variety of host, pathogen, and therapy related factors influence the clinical outcome of MRSA bacteraemia.

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Acknowledgments

We are grateful to John Thwaites for his assistance in the molecular diagnostics and Sharon Tomaselli for her work related to population analysis profile of MRSA isolates.

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Authors and Affiliations

  1. Bristol Centre for Antimicrobial Research and Evaluation, North Bristol NHS Trust, Bristol, UK

    M. S. Albur, K. Bowker & A. MacGowan

  2. Department of Mathematics, University of West of England, Bristol, UK

    I. Weir

Authors
  1. M. S. Albur
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  2. K. Bowker
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  3. I. Weir
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  4. A. MacGowan
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Correspondence to M. S. Albur.

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Albur, M.S., Bowker, K., Weir, I. et al. Factors influencing the clinical outcome of methicillin-resistant Staphylococcus aureus bacteraemia. Eur J Clin Microbiol Infect Dis 31, 295–301 (2012). https://doi.org/10.1007/s10096-011-1310-2

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  • DOI: https://doi.org/10.1007/s10096-011-1310-2

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