Volume 18, Number 7—July 2012
Research
Predicting Risk for Death from MRSA Bacteremia1
Mina Pastagia
, Lawrence C. Kleinman, Eliesel G. Lacerda de la Cruz, and Stephen G. Jenkins
, Lawrence C. Kleinman, Eliesel G. Lacerda de la Cruz, and Stephen G. Jenkins
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.
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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