Predictors of mortality in patients with methicillin-resistant Staphylococcus aureus bacteraemia receiving vancomycin therapy

Abstract

The failure of vancomycin in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia has been reported, despite the full susceptibility of the organism to vancomycin. The purpose of this study was to assess novel predictors for mortality in patients with MRSA bacteraemia receiving vancomycin therapy. Fifty-six patients with MRSA bacteraemia receiving vancomycin treatment were prospectively collected from February 2010 through February 2011. Among the 56 patients with MRSA bacteraemia, twelve patients (21.4%) died. Independent predictors of mortality in patients with MRSA bacteraemia receiving vancomycin were underlying liver diseases (OR, 22.64; 95% CI, 1.28-399.26; p=0.033), Pitt’s bacteraemia scores (OR, 1.48; 95% CI, 1.01-2.16; p=0.042), and a level of albumin at the time of culture collection (OR, 0.03; 95% CI, 0.01-0.53; p=0.018). In conclusion, this study showed that a meticulous therapeutic approach should be considered for patients with MRSA bacteraemia with underlying liver diseases, lower levels of albumin at the time of culture collection, and high Pitt’s bacteraemia scores. The level of albumin may be a simple approach for predicting mortality in patients with MRSA bactermeia receiving vancomycin therapy.