Is methicillin-resistant staphylococcus aureus infection associated with higher mortality and morbidity in hospitalized patients? A cohort study of 551 patients from south western India

Aparajita Chatterjee, Shipra Rai, Vasudeva Guddattu, Chiranjay Mukhopadhyay, Kavitha Saravu

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Abstract

Purpose: To determine morbidity and mortality of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) infections in a tertiary health care facility. Methods: A cohort study among hospitalized adult patients with culture proven MRSA or MSSA monoinfection were recruited in a tertiary referral center in South India from November 2011 to December 2012. Results: Of total 551 subjects, 284 (52%) had MRSA and 267 (48%) MSSA infection. A total of 184 (65%) subjects had health care-associated MRSA (HA-MRSA) and 100 (35%) community-associated MRSA (CA-MRSA). Chronic kidney disease and recent antibiotic use had significant association with MRSA. MRSA patients had significant respiratory infection (OR 2.24 [1.04, 5.16]) and bacteremia (OR 2.24 [10.40, 5.16]), relative to MSSA. MSSA group had better survival function compared to MRSA group (P=0.028). Median duration of ICU stays were 5 days (IQR 4, 8) and 2 days (IQR 2, 2) in MRSA and MSSA, respectively. Complications such as acute kidney injury, sepsis, multiorgan dysfunction, need for supportive measures were more in the MRSA group. Conclusion: MRSA imposes a huge burden in Indian scenario and HA-MRSA remains the main culprit. Patients with history of chronic kidney disease and recent use of antibiotics were found to be at a higher risk. Patients with MRSA infections tend to have poorer outcomes in terms of longer hospital stay, greater complications, and mortality.

Original languageEnglish
Pages (from-to)243-250
Number of pages8
JournalRisk Management and Healthcare Policy
Volume11
DOIs
Publication statusPublished - 01-01-2018

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Methicillin-Resistant Staphylococcus aureus
India
Cohort Studies
Morbidity
Mortality
Methicillin
Infection
Staphylococcus aureus
Delivery of Health Care
Chronic Renal Insufficiency
Anti-Bacterial Agents
Health Facilities
Tertiary Healthcare
Bacteremia
Acute Kidney Injury
Tertiary Care Centers
Respiratory Tract Infections
Length of Stay
Sepsis

All Science Journal Classification (ASJC) codes

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

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title = "Is methicillin-resistant staphylococcus aureus infection associated with higher mortality and morbidity in hospitalized patients? A cohort study of 551 patients from south western India",
abstract = "Purpose: To determine morbidity and mortality of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) infections in a tertiary health care facility. Methods: A cohort study among hospitalized adult patients with culture proven MRSA or MSSA monoinfection were recruited in a tertiary referral center in South India from November 2011 to December 2012. Results: Of total 551 subjects, 284 (52{\%}) had MRSA and 267 (48{\%}) MSSA infection. A total of 184 (65{\%}) subjects had health care-associated MRSA (HA-MRSA) and 100 (35{\%}) community-associated MRSA (CA-MRSA). Chronic kidney disease and recent antibiotic use had significant association with MRSA. MRSA patients had significant respiratory infection (OR 2.24 [1.04, 5.16]) and bacteremia (OR 2.24 [10.40, 5.16]), relative to MSSA. MSSA group had better survival function compared to MRSA group (P=0.028). Median duration of ICU stays were 5 days (IQR 4, 8) and 2 days (IQR 2, 2) in MRSA and MSSA, respectively. Complications such as acute kidney injury, sepsis, multiorgan dysfunction, need for supportive measures were more in the MRSA group. Conclusion: MRSA imposes a huge burden in Indian scenario and HA-MRSA remains the main culprit. Patients with history of chronic kidney disease and recent use of antibiotics were found to be at a higher risk. Patients with MRSA infections tend to have poorer outcomes in terms of longer hospital stay, greater complications, and mortality.",
author = "Aparajita Chatterjee and Shipra Rai and Vasudeva Guddattu and Chiranjay Mukhopadhyay and Kavitha Saravu",
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T1 - Is methicillin-resistant staphylococcus aureus infection associated with higher mortality and morbidity in hospitalized patients? A cohort study of 551 patients from south western India

AU - Chatterjee, Aparajita

AU - Rai, Shipra

AU - Guddattu, Vasudeva

AU - Mukhopadhyay, Chiranjay

AU - Saravu, Kavitha

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Purpose: To determine morbidity and mortality of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) infections in a tertiary health care facility. Methods: A cohort study among hospitalized adult patients with culture proven MRSA or MSSA monoinfection were recruited in a tertiary referral center in South India from November 2011 to December 2012. Results: Of total 551 subjects, 284 (52%) had MRSA and 267 (48%) MSSA infection. A total of 184 (65%) subjects had health care-associated MRSA (HA-MRSA) and 100 (35%) community-associated MRSA (CA-MRSA). Chronic kidney disease and recent antibiotic use had significant association with MRSA. MRSA patients had significant respiratory infection (OR 2.24 [1.04, 5.16]) and bacteremia (OR 2.24 [10.40, 5.16]), relative to MSSA. MSSA group had better survival function compared to MRSA group (P=0.028). Median duration of ICU stays were 5 days (IQR 4, 8) and 2 days (IQR 2, 2) in MRSA and MSSA, respectively. Complications such as acute kidney injury, sepsis, multiorgan dysfunction, need for supportive measures were more in the MRSA group. Conclusion: MRSA imposes a huge burden in Indian scenario and HA-MRSA remains the main culprit. Patients with history of chronic kidney disease and recent use of antibiotics were found to be at a higher risk. Patients with MRSA infections tend to have poorer outcomes in terms of longer hospital stay, greater complications, and mortality.

AB - Purpose: To determine morbidity and mortality of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) infections in a tertiary health care facility. Methods: A cohort study among hospitalized adult patients with culture proven MRSA or MSSA monoinfection were recruited in a tertiary referral center in South India from November 2011 to December 2012. Results: Of total 551 subjects, 284 (52%) had MRSA and 267 (48%) MSSA infection. A total of 184 (65%) subjects had health care-associated MRSA (HA-MRSA) and 100 (35%) community-associated MRSA (CA-MRSA). Chronic kidney disease and recent antibiotic use had significant association with MRSA. MRSA patients had significant respiratory infection (OR 2.24 [1.04, 5.16]) and bacteremia (OR 2.24 [10.40, 5.16]), relative to MSSA. MSSA group had better survival function compared to MRSA group (P=0.028). Median duration of ICU stays were 5 days (IQR 4, 8) and 2 days (IQR 2, 2) in MRSA and MSSA, respectively. Complications such as acute kidney injury, sepsis, multiorgan dysfunction, need for supportive measures were more in the MRSA group. Conclusion: MRSA imposes a huge burden in Indian scenario and HA-MRSA remains the main culprit. Patients with history of chronic kidney disease and recent use of antibiotics were found to be at a higher risk. Patients with MRSA infections tend to have poorer outcomes in terms of longer hospital stay, greater complications, and mortality.

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