%0 Journal Article
%T EMRSA-15 Bacteremia is not Associated with a Worse Outcome Compared with Bacteremia Caused by Multidrug-Resistant MRSA
%A Li-Yang Hsu
%A Nidhi Loomba-Chlebicka
%A Tse-Hsien Koh
%A Mei-Ling Kang
%J International Journal of Biomedical Science
%D 2007
%I 
%X EMRS A-15 (ST 22-MRS A-IV) is rapidly replacing the endemic ST 239 health care-associated methicillin- resistant Staphylococcus aureus clone in Singapore. A one-year single-centre cohort study of inpatients with MRS A bacteremia was performed to determine if bacteremia caused by EMRS A-15 was associated with worse outcomes compared to bacteremia caused by the endemic ST239 strain. Strains were identified by antibiotypes, and subsequent validation was performed on a selected sample of MRS A strains via pulsedfield gel electrophoresis and staphylococcal chromosome cassette mec typing. Two hundred and twenty-eight patients with MRS A bacteremia were studied; Seventy-three were infected with EMRS A-15. EMRS A-15- and ST 239-infected patients were similar regarding gender, frequencies of most co-morbidities, and risk factors for adverse outcomes. Similar numbers of EMRS A-15-infected and ST 239-infected patients died (24.7% vs 27.1%, P=0.70) or developed complicated infections (41.1% vs 40.0%, P=0.88). After multivariate analysis, EMRSA-15 as a cause of bacteremia was not significantly associated with either death or development of complicated infections, although inappropriate therapy (5.45-fold, P<0.01) and a respiratory source of bacteremia (4.69, P<0.01) were independently associated with subsequent mortality. The increased propensity of EMRS A-15 for dissemination was not associated with increased virulence in our patients. Further work in determining the mechanisms by which highly transmissible MRS A spreads rapidly is required to better target infection control approaches at these important emerging MRS A clones.
%K bacteremia
%K methicillin resistance
%K mortality
%K Staphylococcus aureus
%K outcomes
%U http://ijbs.org/User/ContentFullTextFrame.aspx?VolumeNo=3&StartPage=98