%0 Journal Article %T Clinical characteristics and analysis of prognostic factors in methicillin-resistant Staphylococcus aureus endocarditis: A retrospective multicenter study in Japan. %A Mitsutake K %A Shinya N %A Seki M %A Ohara T %A Uemura K %A Fukunaga M %A Sakai J %A Nagao M %A Sata M %A Hamada Y %A Kawasuji H %A Yamamoto Y %A Nakamatsu M %A Koizumi Y %A Mikamo H %A Ukimura A %A Aoyagi T %A Sawai T %A Tanaka T %A Izumikawa K %A Takayama Y %A Nakamura K %A Kanemitsu K %A Tokimatsu I %A Nakajima K %A Akine D %J J Infect Chemother %V 0 %N 0 %D 2024 Jun 12 %M 38876203 %F 2.065 %R 10.1016/j.jiac.2024.06.002 %X BACKGROUND: Infective endocarditis (IE) caused by MRSA (methicillin-resistant Staphylococcus aureus) is associated with a high mortality rate. This study aimed to elucidate the characteristics of patients with MRSA-IE in Japan and identify the factors associated with prognosis.
METHODS: This retrospective study included patients with a confirmed diagnosis of IE caused by MRSA, between January 2015 and April 2019.
RESULTS: A total of 65 patients from 19 centers were included, with a mean age of 67 years and 26 % were female. Fifty percent of the patients with IE were had nosocomial infections and 25 % had prosthetic valve involvement. The most common comorbidities were hemodialysis (20 %) and diabetes (20 %). Congestive heart failure was present in 86 % of patients (NYHA class I, II: 48 %; III, IV: 38 %). The 30-day and in-hospital mortality rates were 29 % and 46 %, respectively. Multi-organ failure was the primary cause of death, accounting for 43 % of all causes of death. Prognostic factors for in-hospital mortality were age, disseminated intravascular coagulation, daptomycin and/or linezolid as initial antibiotic therapy, and surgery. Surgical treatment was associated with a lower mortality rate (odds ratio [OR], 0.026; 95 % confidence interval [CI], 0.002-0.382; p = 0.008 for 30-day mortality and OR, 0.130; 95 % CI; 0.029-0.584; p = 0.008 for in-hospital mortality).
CONCLUSIONS: Mortality due to MRSA-IE remains high. Surgical treatment is a significant prognostic predictor of MRSA-IE.