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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Mortality after infection with methicillin-resistant Staphylococcus aureus (MRSA) diagnosed in the community
J A 'Chris' Delaney1, Verena Schneider-Lindner, Paul Brassard
1Division of Clinical Epidemiology, McGill University Health Center, Royal Victoria Hospital, 687 Pine Avenue West, Ross 4,29, Montreal, H3A 1A1, Canada. joseph.delaney@mail.mcgill.ca
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 Kingdom's 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 1 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 1439 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: 3.5-4.7).
Conclusion:
MRSA infections diagnosed in the community are associated with significant mortality in the year after diagnosis.
Insights
Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections significantly increase mortality risk. This study found MRSA diagnoses in the community were linked to a four-fold higher risk of death within one year.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections pose a serious health threat.
- Previous reports indicate these infections can be life-threatening.
Purpose of the Study:
- To assess the mortality risk associated with MRSA infections diagnosed in the community.
Main Methods:
- A population-based cohort study using the UK's General Practice Research Database (GPRD) from 2001-2004.
- Included 1439 MRSA patients and 14,090 controls, all over 18, with no prior hospitalizations.
- Followed patients for 1 year to identify deaths and hospitalizations, using Cox proportional hazards models.
Main Results:
- The MRSA cohort had a mean age of 70, with higher comorbidity prevalence.
- Within one year, 21.8% of MRSA patients died compared to 5.0% of non-MRSA patients.
- Community-diagnosed MRSA increased the risk of all-cause mortality (adjusted hazard ratio 4.1).
Conclusions:
- MRSA infections diagnosed in the community are associated with substantial mortality.
- A significant increase in death risk is observed in the year following a community MRSA diagnosis.
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