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Staphylococcus aureus Endocarditis: A Consequence of Medical Progress

Staphylococcus aureus Endocarditis: A Consequence of Medical Progress

2005;293:3012-3021 | Vance G. Fowler, Jr. MD, MHS, Jose M. Miro, MD, PhD, Bruno Hoen, MD, PhD, Christopher H. Cabell, MD, MHS, Elias Abrutyn, MD, Ethan Rubinstein, MD, LLb, G. Ralph Corey, MD, Denis Spelman, MD, Suzanne F. Bradley, MD, Bruno Bartsic, MD, PhD, Paul A. Pappas, MS, Kevin J. Anstrom, PhD, Dannah Wray, MD, Claudio Q. Fortes, MD, Ignasi Anguera, MD, Eugene Athan, MD, Philip Jones, MD, Jan T. M. van der Meer, MD, Tom S. J. Elliott, PhD, DSc FRCPath, Donald P. Levine, MD, Arnold S. Bayer, MD
The study documents the global emergence of healthcare-associated *Staphylococcus aureus* (S aureus) endocarditis (IE) and methicillin-resistant *S aureus* (MRSA) IE, and evaluates regional variations in patients with S aureus IE. The International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) enrolled 1779 patients with definite IE from 39 medical centers in 16 countries between June 2000 and December 2003. *S aureus* was the most common pathogen, accounting for 31.4% of cases. Healthcare-associated IE was the most common form of S aureus IE, with 218 patients (39.1%) infected. Patients with healthcare-associated IE were more likely to be from the United States, older, and more likely to be infected with MRSA. In-hospital mortality was higher in patients with healthcare-associated IE, and persistent bacteremia was independently associated with MRSA IE. The findings highlight the increasing importance of healthcare-associated IE and the need for improved infection control measures.The study documents the global emergence of healthcare-associated *Staphylococcus aureus* (S aureus) endocarditis (IE) and methicillin-resistant *S aureus* (MRSA) IE, and evaluates regional variations in patients with S aureus IE. The International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) enrolled 1779 patients with definite IE from 39 medical centers in 16 countries between June 2000 and December 2003. *S aureus* was the most common pathogen, accounting for 31.4% of cases. Healthcare-associated IE was the most common form of S aureus IE, with 218 patients (39.1%) infected. Patients with healthcare-associated IE were more likely to be from the United States, older, and more likely to be infected with MRSA. In-hospital mortality was higher in patients with healthcare-associated IE, and persistent bacteremia was independently associated with MRSA IE. The findings highlight the increasing importance of healthcare-associated IE and the need for improved infection control measures.
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