Community-acquired methicillin-resistant Staphylococcus aureus endocarditis in the Detroit Medical Center

Between June 1980 and September 1981 we evaluated 24 cases of endocarditis from methicillin-resistant Staphylococcus aureus. All of the cases occurred in drug addicts and all were community-acquired. The patients ranged in age from 21 to 59 years and represented an older population than that generally reported for bacterial endocarditis in addicts. Men and women were equally represented (one man presented twice). This unusually high proportion of women may reflect a difference in the rate and location of carriage of methicillin-resistant S. aureus compared with that of methicillin-sensitive staphylococci. Three patients died, one of whom had signed out of the hospital on the 14th day and returned moribund 27 days later. Vancomycin treatment for 28 days was adequate therapy for most patients.