scholarly journals Comparing Echocardiographic Modalities in Native-Valve Infective Endocarditis Due to Methicillin-Resistant Staphylococcus Aureus in People Who Inject Drugs

Cureus ◽  
2021 ◽  
Author(s):  
James Livesay ◽  
Tyler Coombes ◽  
Jared Spoons ◽  
Steven Dolacky ◽  
Mahmoud Shorman
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
People Who Inject Drugs ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Native Valve ◽  
Methicillin Resistant

scholarly journals 686. Comparing Treatments of Methicillin-Resistant Staphylococcus aureus Infective Endocarditis by People Who Inject Drugs

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S445-S446
Author(s):  
Nicholas Rebold ◽  
Sara Alosaimy ◽  
Abdalhamid M Lagnf ◽  
Dana Holger ◽  
Michael J Rybak
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Combination Therapy ◽  
People Who Inject Drugs ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Source Control ◽  
Chi Square ◽  
Methicillin Resistant

Abstract Background People who inject drugs (PWID) are at high risk for infective endocarditis (IE) with high-mortality pathogens such as methicillin-resistant Staphylococcus aureus (MRSA). Stigma against PWID may cause differences in treatment and outcomes between these patients infected with MRSA IE. Methods Single center retrospective cohort study from August 2006 to February 2021 that includes adult patients diagnosed with IE. Primary outcomes included 90-day all-cause mortality, 60-day MRSA recurrence, 60-day readmission, and hospital length of stay (LOS). Statistical analysis was performed by chi-square, t-test, and Mann-Whitney-U as appropriate. Results A total of 214 patients were diagnosed with MRSA IE; 89 PWID and 125 non-PWID. The mean (SD) age was 47.4±12.4 years (PWID) vs 59.3 ±16.0 years (non-PWID) (p< 0.001). Patients were primarily male (56%), but differed in terms of race 34% African-American (AA) (PWID) vs 66% AA (non-PWID) (p< 0001). Mean APACHE II scores differed between groups: 16(±9.9) (PWID) vs 19(±8.1) (non-PWID) (p< 0.008). Among patients who cleared bacteremia, mean (SD) duration was 5.7(±3.9) days and was not significant between groups (p< 0.64). Valve-type was 93% native and 7% prosthetic and not different between groups (p< 0.16). Infectious Diseases consult did not differ at 96% overall (p< 0.31), but pursuit of source control nearly reached significance at 27% for PWID vs 41% non-PWID (p< 0.06). Similarly, use of combination therapy daptomycin and ceftaroline was nearly significant: 21% (PWID) vs 12% (non-PWID) (p< 0.09). Odds ratio of PWID and combination therapy remained non-significant after regression: 0.39(0.14-1.1,p< 0.07). Primary 90-day mortality was lower in PWID vs non-PWID (15% vs 30%) respectively (p< 0.01), but did not differ in 60-day MRSA recurrence (p< 1.0) at 9%, 60-day readmission (p< 1.0) at 33%, or median LOS (IQR) (p< 0.46) at 15 (10-24) days overall. Conclusion While PWID are significantly younger, less critically ill, and have lower mortality compared to non-PWID, they have similar LOS, MRSA recurrence, and readmission rates. Analyses suggest a potential difference in the pursuit of source control and combination therapy among PWID, however more studies may be needed to achieve significance. Disclosures Michael J. Rybak, PharmD, MPH, PhD, Paratek Pharmaceuticals (Research Grant or Support)

scholarly journals First reported case of infective endocarditis caused by community-acquired methicillin-resistant Staphylococcus aureus not associated with healthcare contact in Brazil

2008 ◽  
Vol 12 (6) ◽  
pp. 541-543 ◽  
Author(s):  
Claudio Querido Fortes ◽  
Claudia Adelino Espanha ◽  
Flavio Pedreira Bustorff ◽  
Bruno Cordeiro Zappa ◽  
Adriana Lucia Pires Ferreira ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistant
Sign in / Sign up

Export Citation Format

Share Document