BACKGROUND: This study sought to determine the impact of methicillin resistance on clinical features and outcomes in patients with Staphylococcus aureus (SA) infective endocarditis (IE).METHODS: Retrospective chart review. Univariate and forward stepwise logistic regressions were conducted to determine which factors significantly affected death and systemic embolism.RESULTS: From October 1995 to April 2002, 57 patients with a definite diagnosis of IE caused by SA were included: 28 cases of methicillin-sensitive SA infection and 29 methicillin-resistant SA (MRSA) infection. Patients with MRSA infection are more likely to have old age, underlying diseases, history of hospitalization within the last 6 months, nosocomial infection, and antibiotic use within the last 3 months. Patients with MRSA infection had clinical presentation of less systemic embolism and more sepsis and had a higher 3-month mortality rate. Methicillin resistance is an independent positive predictor of death and a negative predictor of systemic embolism.CONCLUSIONS: MRSA became a dominant cause of SA IE. Although it caused a lower incidence of systemic embolism, MRSA infection had a higher mortality rate because of sepsis.
Adolescent Adult