MRSA Infection

MRSA & the heart, more dying?

Abstract | Increasing incidence and mortality of infective endocarditis: a population-based study through a record-linkage system.

1,863 subjects were hospitalized for IE, with a corresponding crude rate of 4.4 per 100,000 person-years, increasing from 4.1 in 2000-2002 to 4.9 in 2006-2008 (p=0.003). Median age was 68 years; 39% of subjects were hospitalized in the three preceding months. 23% of patients underwent a cardiac valve procedure in the index admission or in the following year. Inhospital mortality was 14% (19% including hospital transfers); 90-days and 365-days mortality rose through the study years. Mortality increased with age and the Charlson comorbidity index, in subjects with previous hospitalizations for heart failure, and (in the subcohort with microbiological data) in IE due to Staphylococci (40% of IE). Conclusions The study demonstrates an increasing incidence and mortality for IE over the last decade. Analyses of electronic archives provide a region-wide picture of IE, overcoming referral biases affecting single clinic or multicentric studies, and therefore represent a first fundamental step to detect critical issues related to IE.

Fighting MRSA in cardiac patients

Transposition of greater omentum in deep sternal w... [Thorac Cardiovasc Surg. 2011] - PubMed result.

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus epidermidis (MRSE) are an increasing problem in deep sternal wound infections (DSWI) after cardiac surgery. METHODS: Between 2005 and 2009, recalcitrant methicillin-resistant Staphylococcus was found in 21 patients with complicated DSWI, and a transposition of the greater omentum (TGO) was finally performed. A positive microbial culture at the time of procedure was present in all patients. The hospital course was reviewed discretely for MRSA and MRSE. RESULTS: Median patient age was 72.3 years (range 60.8-79.7); 76 % of patients were male. Time from the first sternal revision until consecutive open wound therapy due to re-infection and total hospital stay was longer for MRSA compared to MRSE (38 vs. 14 days, P = 0.003, and 141 vs. 91 days, P = 0.007, respectively). The period from cardiac surgery to TGO was likewise prolonged for MRSA (78 vs. 55 days, P = 0.045), whereas in-hospital mortality and one-year mortality rate did not differ. CONCLUSION: TGO remains a good treatment option for DSWI type IV. Microbial findings determine the clinical course; nevertheless in-hospital mortality remains low for both MRSA and MRSE infection.

Daptomycin Associated With Better Outcomes Than Vancomycin in Patients With MRSA Endocarditis

News - Daptomycin Associated With Better Outcomes Than Vancomycin in Patients With MRSA Endocarditis: Presented at ECCMID.

Daptomycin appears to be associated with a better outcome compared with vancomycin in patients with methicillin-resistant Staphylococcus aureus (MRSA) that show reduced susceptibility to vancomycin, researchers said here at the 20th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID). These effects appear particularly relevant in patients with MRSA endocarditis.