Methicillin resistant Staphylococcus aureus endocarditis in an Australian tertiary hospital: 1991-2006

Rogers, Benjamin A., Drake, Anne K. and Spelman, Denis (2009) Methicillin resistant Staphylococcus aureus endocarditis in an Australian tertiary hospital: 1991-2006. Heart Lung and Circulation, 18 3: 208-213. doi:10.1016/j.hlc.2008.10.016


Author Rogers, Benjamin A.
Drake, Anne K.
Spelman, Denis
Title Methicillin resistant Staphylococcus aureus endocarditis in an Australian tertiary hospital: 1991-2006
Formatted title
Methicillin resistant Staphylococcus aureus endocarditis in an Australian tertiary hospital: 1991-2006
Journal name Heart Lung and Circulation   Check publisher's open access policy
ISSN 1443-9506
1444-2892
Publication date 2009-06
Year available 2008
Sub-type Article (original research)
DOI 10.1016/j.hlc.2008.10.016
Volume 18
Issue 3
Start page 208
End page 213
Total pages 6
Place of publication Chatswood, N.S.W., Australia
Publisher Elsevier Australia
Language eng
Formatted abstract
Background: Methicillin resistant Staphylococcus aureus (MRSA) endocarditis is increasing in frequency and has a high mortality. This condition has not been specifically described in an Australian population previously.
Aim: To describe the characteristics, management and outcomes of patients with MRSA endocarditis in an Australian hospital and identify trends in this group over 16 years.
Methods: Retrospective case series of MRSA endocarditis patients between 1991 and 2006.
Results: Between 1991 and 2006, 27 patients were managed for MRSA endocarditis. This group consisted of 18 males (67%). The median age was 64 years. Infection was related to a prosthetic valve or annular ring in 10 patients (37%). The most common comorbidities were diabetes mellitus 8 (30%) and malignancy 8 (30%). Nosocomial acquisition occurred in 16 (59%), non-nosocomial healthcare associated acquisition in 10 (37%) and community acquisition in 1 (4%). Management was with a single antimicrobial agent in 5 (19%) and combination antimicrobial therapy in 22 (81%). Surgery was undertaken in 16 patients (59%). The mortality was 66%. Over this time there was increased non-nosocomial acquisition and presentations to non-tertiary hospitals. There was no clear improvement in survival over the 16 years.
Conclusion: In this Australian setting, MRSA endocarditis was mostly nosocomial or healthcare associated. Common characteristics were older patients with multiple co-morbidities. Despite high rates of combination antibiotic therapy and surgery, mortality was very high. There is a need for randomised comparative antibiotic studies.
Keyword Endocarditis
Bacterial
Staphylococcus aureus
Methicillin resistance
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes Available online 31 December 2008

Document type: Journal Article
Sub-type: Article (original research)
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Created: Wed, 19 Oct 2011, 09:55:24 EST by Benjamin Rogers on behalf of School of Medicine