{Reference Type}: Journal Article
{Title}: Clinical characteristics and analysis of prognostic factors in methicillin-resistant Staphylococcus aureus endocarditis: A retrospective multicenter study in Japan.
{Author}: Mitsutake K;Shinya N;Seki M;Ohara T;Uemura K;Fukunaga M;Sakai J;Nagao M;Sata M;Hamada Y;Kawasuji H;Yamamoto Y;Nakamatsu M;Koizumi Y;Mikamo H;Ukimura A;Aoyagi T;Sawai T;Tanaka T;Izumikawa K;Takayama Y;Nakamura K;Kanemitsu K;Tokimatsu I;Nakajima K;Akine D;
{Journal}: J Infect Chemother
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jun 12
{Factor}: 2.065
{DOI}: 10.1016/j.jiac.2024.06.002
{Abstract}: <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>This retrospective study included patients with a confirmed diagnosis of IE caused by MRSA, between January 2015 and April 2019.<BR><B>RESULTS: </B>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).<BR><B>CONCLUSIONS: </B>Mortality due to MRSA-IE remains high. Surgical treatment is a significant prognostic predictor of MRSA-IE.