%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.