METHICILLIN SENSITIVE AND RESISTANT STAPHYLOCOCCUS AUREUS IN BLOODSTREAM INFECTIONS: FREQUENCY, OUTCOME AND COST OF TREATMENT IN THE SOUTHERN PART OF BOSNIA AND HERZEGOVINA

Abstract

Background: Bloodstream infections (BSI) encountered in hospitals are one of the most complex infections that pose a great challenge. Methicillin-sensitive and Methicillin-resistant Staphylococcus aureus are common causes of severe bloodstream infections that are associated with organ failure and septic shock. Hence, better knowledge of the incidence of BSI caused by MRSA and MSSA and adequate antibiotic treatment are important to reduce length of hospital stay and improve treatment outcomes.
Subjects and methods: The aim of this study was to analyze the frequency of BSI with MSSA and MRSA in adult patients who were hospitalized at the same time and same departments of the University Hospital Centre Mostar in the course of six years.
Results: The incidence of BSI with MSSA and MRSA was shown to be 33,21% and 17,99%, respectively. Average age of patients infected with MRSA was 61.5 years and with MSSA was 67.5 years. MSSA and MRSA BSI were more common in men with average of 69,79% and 80,77%, respectively. In both groups of patients, one third had no associated diseases. Patients that had associated chronic disease with mild or moderately severe activity limitations constructed 41,67% with MSSA and 46,15% with MRSA. Cardiovascular diseases were most common chronic disease in both groups, 33.33% for MSSA and 40.38% for MRSA. Treatment of the of subjects with MSSA BSI averaged 15 days and lasted significantly shorter when compared to MRSA BSI treatment that averaged 36 days. Patients with MRSA BSI were more treated in middle and/or high-risk departments and with inadequate antibiotic therapy. MRSA BSI patients were more often mechanically ventilated (69,23%), which contributes to a higher cost of treatment (average of 8032.5€ in total) and higher drug consumption when compared to the MSSA BSI patients. The death rate was higher in patients treated for MRSA BSI and averaged 67.31%.
Conclusions: The results of this study are promising since they can be used in practice by clinicians as a guideline for choosing adequate antibiotics, and improve course of treatment, length, outcome and cost.