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Heart Lung Circ. 2009 Jun;18(3):208-13. doi: 10.1016/j.hlc.2008.10.016. Epub 2008 Dec 31.

Methicillin resistant Staphylococcus aureus endocarditis in an Australian tertiary hospital: 1991-2006.

Author information

1
Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Grattan Street, Parkville 3050, Victoria, Australia. benrogers@netspace.net.au

Abstract

BACKGROUND:

Methicillin resistant Staphylococcus aureus (MRSA) endocarditis is increasing in frequency and has a high mortality. This condition has not been specifically described in an Australian population previously.

AIM:

To describe the characteristics, management and outcomes of patients with MRSA endocarditis in an Australian hospital and identify trends in this group over 16 years.

METHODS:

Retrospective case series of MRSA endocarditis patients between 1991 and 2006.

RESULTS:

Between 1991 and 2006, 27 patients were managed for MRSA endocarditis. This group consisted of 18 males (67%). The median age was 64 years. Infection was related to a prosthetic valve or annular ring in 10 patients (37%). The most common comorbidities were diabetes mellitus 8 (30%) and malignancy 8 (30%). Nosocomial acquisition occurred in 16 (59%), non-nosocomial healthcare associated acquisition in 10 (37%) and community acquisition in 1 (4%). Management was with a single antimicrobial agent in 5 (19%) and combination antimicrobial therapy in 22 (81%). Surgery was undertaken in 16 patients (59%). The mortality was 66%. Over this time there was increased non-nosocomial acquisition and presentations to non-tertiary hospitals. There was no clear improvement in survival over the 16 years.

CONCLUSION:

In this Australian setting, MRSA endocarditis was mostly nosocomial or healthcare associated. Common characteristics were older patients with multiple co-morbidities. Despite high rates of combination antibiotic therapy and surgery, mortality was very high. There is a need for randomised comparative antibiotic studies.

PMID:
19119075
DOI:
10.1016/j.hlc.2008.10.016
[Indexed for MEDLINE]

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