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Staphylococcus aureus bacteremia and endocarditis: the Grady Memorial Hospital experience with methicillin-sensitive S aureus and methicillin-resistant S aureus bacteremia
- Source :
- American Heart Journal. 147:536-539
- Publication Year :
- 2004
- Publisher :
- Elsevier BV, 2004.
-
Abstract
- Staphylococcus aureus has become the leading cause of endocarditis in most published series, and nosocomial acquisition is becoming more frequent. Previous studies involved community acquired methicillin-sensitive S aureus (MSSA), but recently, methicillin-resistant S aureus(MRSA) infection has increased. This may reflect the growing presence of this microorganism in clinical practice. Few data exist comparing the relative rates of endocarditis with MSSA and MRSA bacteremia. The purpose of this study was to compare these rates in a bacteremic population referred for diagnostic echocardiography.Since July 1999, the demographic and clinical information of 104 consecutive patients with at least 2 blood cultures with positive results for S aureus who were referred for echocardiography to be evaluated for endocarditis at Grady Memorial Hospital (Atlanta, Ga) have been entered into a database. This database has further been restricted to patients who have undergone either a transesophageal echocardiogram or a transthoracic echocardiogram.Of the 104 patients with S aureus bacteremia, 53 had an infection of MSSA and 51 had an infection of MRSA. There were 33 patients (31.7%) with echocardiographically confirmed endocarditis, 23 patients (43.4%) in the MSSA group versus 10 patients (19.6%) in the MRSA group (P.009). Community-acquired MSSA bacteremia was the cause of most of the community-acquired S aureus endocarditis (20 patients [87%] vs 3 patients [30%], P =.004), and the nosocomial-acquired MRSA bacteremia was the cause of most of the nosocomial-acquired S aureus endocarditis (3 patients [13%] vs 7 patients [70%], P =.0001).Our study confirms that S aureus bacteremia is associated with high rates of endocarditis. MSSA bacteremia is associated with higher rates of endocarditis than MRSA. Community MSSA is the cause of most of the community endocarditis, whereas nosocomial MRSA is the cause of most of the MRSA endocarditis. Patients with S aureus bacteremia should be aggressively evaluated for endocarditis.
- Subjects :
- Adult
Male
Staphylococcus aureus
medicine.medical_specialty
Meticillin
Micrococcaceae
Population
Bacteremia
Transesophageal echocardiogram
medicine.disease_cause
Catheters, Indwelling
Internal medicine
medicine
Humans
Endocarditis
education
Cross Infection
education.field_of_study
biology
medicine.diagnostic_test
business.industry
Endocarditis, Bacterial
Middle Aged
Staphylococcal Infections
biochemical phenomena, metabolism, and nutrition
bacterial infections and mycoses
biology.organism_classification
medicine.disease
Surgery
Community-Acquired Infections
Female
Methicillin Resistance
Transthoracic echocardiogram
Cardiology and Cardiovascular Medicine
business
Echocardiography, Transesophageal
medicine.drug
Subjects
Details
- ISSN :
- 00028703
- Volume :
- 147
- Database :
- OpenAIRE
- Journal :
- American Heart Journal
- Accession number :
- edsair.doi.dedup.....9112fcfd26d6286345ed23910613606b