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Volume 18, Number 7—July 2012

Research

Predicting Risk for Death from MRSA Bacteremia1

Mina PastagiaComments to Author , Lawrence C. Kleinman, Eliesel G. Lacerda de la Cruz, and Stephen G. Jenkins
Author affiliations: The Rockefeller University, New York, New York, USA (M. Pastagia); Mount Sinai School of Medicine, New York (L.C. Kleinman, E.G. Lacerda de la Cruz); and Weill Cornell School of Medicine, New York (S.G. Jenkins)

Main Article

Table 3

Clinical characteristics for patients with MRSA bacteremia by strain type, New York, New York, USA, 2002–2007*

Characteristic VISA, n = 55 hVISA, n = 55 non–VISA/hVISA MRSA, n = 589 p value
Age, mean y ± SD† 58.7 ± 16.5 58.7 ± 16.5 63 ± 17.3 0.04
Length of stay, mean d ± SD 33.7 ± 41.4 30.9 ± 22.7 34 ± 41.9 0.49
Days to negative culture, mean ± SD 3.7 ± 2.8 3.6 ± 3.2 4.3 ± 4.8 0.98
Male sex 29 (52.7) 28 (50.9) 340 (57.7) 0.51
Race/ethnicity
White 19 (34.5) 21 (38.2) 238 (40.4) 0.59
Black 15 (27.3) 14 (25.5) 160 (27.2) 0.96
Hispanic 12 (21.8) 7 (12.7) 123 (20.9) 0.34
Asian 9 (16.4) 10 (18.2) 65 (11.0) 0.17
General
Hospitalization within 1 mo of MRSA infection 29 (52.7) 17 (30.9) 295 (50.1) 0.02
Prior MRSA infection 22 (40.0) 7 (12.7) 159 (27.0) 0.006
Prior vancomycin exposure 34 (61.8) 25 (45.5) 272 (46.2) 0.08
Vancomycin trough >15 µg/mL 34 (61.8) 25 (45.5) 387 (65.7) 0.0005
Inappropriate antimicrobial drug therapy 12 (21.8) 4 (7.3) 66 (11.2) 0.09
Infectious diseases consultation 34 (61.8) 23 (41.8) 404 (68.6) 0.0003
Health care–associated hospital infection 19 (34.5) 28 (50.9) 340 (57.7) 0.003
Health care–associated community infection 31 (56.4) 25 (45.5) 241 (40.9) 0.08
Concurrent conditions
Renal insufficiency 35 (63.6) 29 (52.7) 309 (52.5) 0.48
Chronic hemodialysis 19 (34.5) 12 (21.8) 128 (21.7) 0.09
Diabetes mellitus 27 (49.1) 18 (32.7) 209 (35.5) 0.11
HIV 5 (9.1) 2 (3.6) 60 (10.2) 0.29
Cardiovascular disease 33 (60.0) 31 (56.4) 399 (67.7) 0.14
Malignancy 14 (25.5) 17 (30.9) 117 (19.9) 0.11
Transplant 7 (12.7) 11 (20.0) 46 (7.8) 0.007
Cirrhosis 22 (40.0) 14 (25.5) 78 (13.2) <0.0001
Steroids 17 (30.9) 12 (21.8) 193 (32.8) 0.25
Surgery <3 mo before MRSA infection 14 (25.5) 19 (34.5) 271 (46.0) 0.005
Implanted device 8 (14.5) 7 (12.7) 151 (25.6) 0.02
Intensive care unit stay 23 (41.8) 26 (47.3) 273 (46.3) 0.96
Infection source
Central venous catheter 27 (49.1) 33 (60.0) 242 (41.1) 0.04
Pneumonia 10 (18.2) 6 (10.9) 39 (6.6) 0.62
Endocarditis 7 (12.7) 3 (5.5) 81 (13.8) 0.22
Wound/skin or soft tissue 10 (18.2) 10 (18.2) 92 (15.6) 0.80
Bone/joint 6 (10.9) 1 (1.8) 65 (11.0) 0.10
Vascular graft 2 (3.6) 1 (1.8) 17 (2.9) 0.85
Death within 90 d of MRSA infection 15 (27.3) 14 (25.5) 161 (27.3) 0.38

*Values are no. (%) with a given variable per strain type unless otherwise indicated. MRSA, methicillin-resistant Staphylococcus aureus; VISA, vancomycin-intermediate S. aureus strains, hVISA, heteroresistant vancomycin-intermediate S. aureus strains.
†N = 699.

Main Article

1Parts of the data in this article were presented at the 48th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy/Infectious Diseases Society of America Meeting, October 25–28, 2008, Washington, DC, USA; and the 19th European Congress of Clinical Microbiology and Infectious Diseases Meeting, May 16–19, 2009, Helsinki, Finland.

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