The prevalence of both community-acquired and hospital-acquired methicillin-resistant Staphylococcus Aureus (MRSA) has been dramatically increasing around the world. MRSA infection is known to have a high mortality rate yet there are few studies assessing predictors of mortality in these patients.
We conducted a retrospective chart-review in a 350-bed community-hospital in Brooklyn, New York. Based on a microbiologic database, we found 126 patients with either community-acquired or hospital-acquired MRSA. Infections that developed <48 hours after admission or were present on admission were defined as community-acquired. Infections that developed >48 hours after admission were deemed hospital-acquired. We evaluated various factors (such as age, gender, ethnicity, site of infection, etc.) potentially predictive of mortality including trimethoprim/sulfamethoxazole (TMP/SMX) sensitivity.
Overall, 108 (85.72%) of 126 patients survived; 33 patients had hospital-acquired MRSA and 96 had community-acquired MRSA. We found that patients with TMP/SMX-resistant MRSA were more likely to expire than patients with TMP/SMX-susceptible MRSA (p<0.05).
Predictors of mortality would be useful to better define and delineate patients with MRSA infections. We found that trimethoprim/sulfamethoxazole resistance is associated with increased mortality in patients with MRSA infections. Hospital-acquired MRSA had a higher mortality rate than community-acquired MRSA.
The presence of trimethoprin/sulfamethoxazole resistance may need to be monitored so that a more aggressive approach to treatment may be rendered in patients with methicillin-resistant Staphylococcus Aureus infections.
Amy Pate, No Financial Disclosure Information; No Product/Research Disclosure Information