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Staphylococcemia mortality: Influence of methicillin resistance and site of infection acquisition in a patient's cohort from Medellin, Colombia

Abstract:

Methicillin-resistant Staphylococcus aureus bacteraemia (mrsa) incidence seems to be increasing in some countries. This phenomenon has also been detected in Colombia. objective. To estimate the potential interaction between the place of acquisition of the infection and antimicrobial resistance, in hospital lethality of patients with S. aureus bacteremia. methods. Patients retrospective cohort with microbiological isolation for S. aureus. The information related to the episode was recorded. The effect interaction was estimated with a stratified analysis of Mantel-Hanzel. results. 1 201 patients were included, median age 57 years (iqr = 42-69). In 540 (45%) they had nosocomial bacteraemia, 24.4% of them (n = 292) were mrsa. In 301 (25%) bacteraemia of the community, the frequency of mrsa was 25.6% (n = 77). Mortality was 25.7% (n = 139) for nosocomial bacteraemia and 30.6% (n = 92) for community bacteraemia. No differences were found in hospital mortality due to mrsa or S. aureus meticilino sensible (sasm). In the stratified analysis, no differences were found in the risk of death of sarm vs. sasm according to the place of acquisition (p = 0.36). Hospital mortality was different (p <0.0001) according to the acquisition of infection in the community (30.6%), hospital (25.7%) or associated with health care (16.4%).