Comparable clinical course between coagulase-negative staphylococcal and Staphylococcus aureus endocarditis

Infection ◽  
2022 ◽  
Author(s):  
Marie Bourget ◽  
Marie Pasquie ◽  
Hélène Charbonneau ◽  
Eric Bonnet
Keyword(s):  
Staphylococcus Aureus ◽  
Clinical Course ◽  
Staphylococcus Aureus Endocarditis ◽  
And Staphylococcus Aureus

scholarly journals Evolution of antimicrobial resistance and mortality in Staphylococcus aureus endocarditis during 15 years in a university hospital

2021 ◽  
Author(s):  
Marcos Rodríguez Esteban ◽  
◽  
Jesús Ode Febles ◽  
Sara Isabel Miranda Montero ◽  
María Ramos López ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Predictive Factors ◽  
Significant Variation ◽  
Clinical Course ◽  
University Hospital ◽  
Index Point ◽  
Factors Associated ◽  
Staphylococcus Aureus Endocarditis ◽  
The Right

Introduction. One of the most aggressive microorganisms in infective endocarditis (IE) is Staphylococcus aureus. We analyse the resistance of S. aureus to antibiotics and its impact on the clinical course of IE in a recent 15-year period. Methods. Retrospective study of patients with IE in a university hospital from 2005 to 2019. Bivariate and multivariate analysis of severity at admission, comorbidities, minimum inhibitory concentrations (MIC) and mortality. Results. Of the 293 IE cases, 66 (22.5%) were due to S. aureus, and 21 (7.2%) were methicillin-resistant S. aureus (MRSA). The prevalence of strains with a MIC to vancomycin ≥ 1mg/L increased from 4.8% to 63.6% (p <0.001) and the cases of MRSA from 38 to 27.3% (p = 0.045). Older age (p= 0.02), comorbidity (p <0.01) and nosohusial origin (p = 0.01), were factors associated with MRSA. But the antimicrobial resistance and severity on admission were not associated with exitus; predictive factors were the right-sided IE (OR = 0.08; 95% CI: 0.01-0.51), comorbidities (OR per Charlson index point = 1.30; 95% CI: 1.01-1.69) and creatinine on admission (OR per mg / dL = 1.56; 95% CI = 1.01- 2.35; p = 0.04). Conclusion. We have experienced an increase in IE cases with MIC to vancomycin ≥ 1mg/L, without significant variation in infections due to MRSA. Antimicrobial resistance was not associated with mortality, but comorbidity and left involvement were predictive factors.

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