The Effect of Staphylococcal Cassette Chromosome mec (SCCmec) Type on Clinical Outcomes in Methicillin-Resistant Staphylococcus aureus Bacteremia

Details

• Alternative Title:
  J Infect
• Personal Author:
  Han, Jennifer H. ; Edelstein, Paul H. ; Bilker, Warren B. ; Lautenbach, Ebbing
• Description:
  Objectives
  
  The impact of staphylococcal cassette chromosome mec (SCCmec) type on mortality in methicillin-resistant Staphylococcus aureus (MRSA) infections remains unclear. The objective of this study was to determine the association between SCCmec type and mortality in MRSA bacteremia.
  
  Methods
  
  A cohort study of patients who were hospitalized with MRSA bacteremia was conducted within a university health system. A multivariable logistic regression model was developed to evaluate the association of SCCmec type with 30-day in-hospital mortality.
  
  Results
  
  Thirty-four of a total of 184 patients with MRSA bacteremia died, resulting in a mortality rate of 18.5%. Adjusted risk factors for 30-day mortality included APRDRG Risk of Mortality score (odds ratio [OR], 5.33; 95% confidence interval [CI], 2.28-12.4; P<0.001), white blood cell count (OR, 1.09; 95% CI, 1.03-1.15; P=0.002), and malignancy (OR, 3.25; 95% CI, 1.17-9.02; P=0.02). On multivariable analyses, SCCmec II was not significantly associated with mortality in patients with MRSA bacteremia (OR, 1.85; 95% CI, 0.69-4.92; P=0.22).
  
  Conclusions
  
  Mortality in MRSA bacteremia was independent of SCCmec type. SCCmec type II is most likely a marker for disease severity rather than a direct mediator of mortality. Further research is needed to elucidate the factors associated with poor clinical outcomes in MRSA infections.
  
  
• Subjects:
  Bacteremia Bacterial Proteins Cohort Studies Female Hospitalization Humans Male Methicillin-Resistant Staphylococcus Aureus Methicillin Resistance Middle Aged Molecular Typing Multivariate Analysis Odds Ratio Penicillin-Binding Proteins Retrospective Studies Risk Factors Staphylococcal Infections Survival Rate Treatment Outcome

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• Source:
  J Infect. 2012; 66(1):41-47.
• Pubmed ID:
  22960078
• Pubmed Central ID:
  PMC3518704
• Document Type:
  Journal Article
• Funding:
  K24 AI080942/AI/NIAID NIH HHS/United States ; L30 AI101162/AI/NIAID NIH HHS/United States ; U54-CK000163/CK/NCEZID CDC HHS/United States
• Volume:
  66
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:24bb8bbda7639a10a6bada3e6905bac73526d5f55bd9c3972bcc9596778bdd0d
• Download URL:
  https://stacks.cdc.gov/view/cdc/33491/cdc_33491_DS1.pdf
• File Type:
  [PDF - 300.50 KB ]