Risk factors for nosocomial infective endocarditis in patients with methicillin-resistant Staphylococcus aureus bacteremia.

BACKGROUND AND

OBJECTIVE

Nosocomial infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are increasing. Only a few studies of MRSA infective endocarditis have been conducted, and none have reported its risk factors. We sought to determine the host-related risk factors for infective endocarditis in patients with nosocomial MRSA bacteremia.

SETTING

A 2,000-bed, university-affiliated, tertiary-care hospital.

PATIENTS: Thirty-one patients with nosocomial MRSA infective endocarditis between October 1996 and May 2003.

DESIGN

A retrospective chart review was conducted. Data were compared with those from a control group of patients with nosocomial MRSA bacteremia. Logistic regression was used to identify independent risk factors for nosocomial infective endocarditis.

RESULTS

Compared with patients who had nosocomial MRSA bacteremia and no infective endocarditis, patients who had infective endocarditis had a higher incidence of chronic liver disease and a lower incidence of immunodeficiency. The risk of developing infective endocarditis was approximately 10% for patients with nosocomial MRSA bacteremia.

CONCLUSION

Patients with MRSA bacteremia and underlying chronic liver disease were prone to infective endocarditis.