Infective endocarditis caused by USA300 methicillin-resistant Staphylococcus aureus (MRSA)

• Published in: International journal of antimicrobial agents 2007-07, Vol.30 (1), p.72-77
• Main Authors: Haque, N.Z, Davis, S.L, Manierski, C.L, Vager, D, Donabedian, S.M, Perri, M.B, Sabbagh, R, Cheema, F, Zervos, M.J
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Anti-Bacterial Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial diseases; Biological and medical sciences; CA-MRSA; Cardiology. Vascular system; Cluster Analysis; Community-Acquired Infections - microbiology; Cross Infection - microbiology; DNA Fingerprinting; Electrophoresis, Gel, Pulsed-Field; Endocardial and cardiac valvular diseases; Endocarditis; Endocarditis, Bacterial - complications; Endocarditis, Bacterial - drug therapy; Endocarditis, Bacterial - microbiology; Female; Heart; Hospitalization; Hospitals, Teaching; Hospitals, Urban; Human bacterial diseases; Humans; Infectious Disease; Infectious diseases; Length of Stay; Male; Medical sciences; Methicillin Resistance; Middle Aged; Pharmacology. Drug treatments; Staphylococcal Infections - complications; Staphylococcal Infections - drug therapy; Staphylococcal Infections - microbiology; Staphylococcal infections, streptococcal infections, pneumococcal infections; Staphylococcus aureus; Staphylococcus aureus - classification; Staphylococcus aureus - drug effects; Staphylococcus aureus - isolation & purification; Substance Abuse, Intravenous - complications; USA300; Vancomycin
• ISSN: 0924-8579; 1872-7913
• DOI: 10.1016/j.ijantimicag.2007.02.007

Abstract We report seven cases of infective endocarditis caused by USA300 methicillin-resistant Staphylococcus aureus (MRSA) at an urban, tertiary care, academic institution. Five strains were community associated and two were healthcare associated. All patients were injection drug users . Staphylococcus aureus isolates were characterised as USA300-type MRSA using pulsed-field gel electrophoresis. Five cases were right-sided endocarditis and two cases were left-sided. The mean length of in-hospital antimicrobial therapy was 23 days and the mean length of total antibiotic therapy was 55 days. Complications included heart failure resulting in valve replacement in one patient as well as death in that patient. As USA300 strains of MRSA continue to increase in prevalence, clinicians must be aware of the increasing spectrum of illness in considering management and prevention strategies.