Sunday, February 3, 2008

Mortality after infection with methicillin resistant Staphylococcus aureus (MRSA) diagnosed in the community

Mortality after infection with methicillin resistant Staphylococcus aureus (MRSA) diagnosed in the community
BMC Med. 2008 Jan 31

Delaney JA, Schneider-Lindner V, Brassard P, Suissa S.

Background

Outbreak reports suggest that community-acquired Methicillin-resistant Staphylococcus aureus (MRSA) infections can be life-threatening. We conducted a population based cohort study to assess the magnitude of mortality associated with MRSA infections diagnosed in the community.

Methods


We used the United Kingdomas General Practice Research Database (GPRD) to form a cohort of all patients with MRSA diagnosed in the community from 2001 through 2004 and up to ten patients without an MRSA diagnosis. The latter were frequency-matched with the MRSA patients on age, GPRD practice, and diagnosis date. All patients were older than 18 years, had no hospitalization in the 2 years prior to cohort entry, and medical history information of at least 2 years prior to cohort entry. The cohort was followed up for one year and all deaths and hospitalizations were identified. Hazard ratios of all-cause mortality were estimated using the Cox proportional hazards model adjusted for patient characteristics.


Results

The cohort included 1,439 patients diagnosed with MRSA and 14,090 patients with no MRSA diagnosis. Mean age at cohort entry was 70 years in both groups, while co-morbid conditions were more prevalent in the patients with MRSA. Within 1 year, 21.8% of MRSA patients died as compared with 5.0% of non-MRSA patients. The risk of death was increased in patients diagnosed with MRSA in the community (adjusted hazard ratio 4.1; 95% confidence interval: 3.5 to 4.7).

Conclusions

MRSA infections diagnosed in the community are associated with significant mortality in the year after diagnosis.

BMC Medicine