Methicillin-Resistant Staphylococcus Aureus Bacteremia: Epidemiology, Clinical Characteristics, Risk Factors, and Outcomes in a Tertiary Care Center in Riyadh, Saudi Arabia

Sarah A Alhunaif; Sarah Almansour; Raghad Almutairi; Sara Alshammari; Lamia Alkhonain; Bassam Alalwan; Sameera Aljohani; Abdulrahman Alsaedy; Mohammad Bosaeed; Adel Alothman

doi:10.7759/cureus.14934

Methicillin-Resistant Staphylococcus Aureus Bacteremia: Epidemiology, Clinical Characteristics, Risk Factors, and Outcomes in a Tertiary Care Center in Riyadh, Saudi Arabia

Cureus. 2021 May 10;13(5):e14934. doi: 10.7759/cureus.14934.

Affiliations

¹ College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.
² Division of Infectious Diseases, Department of Internal Medicine, King Abdulaziz Medical City - National Guards Health Affairs, Riyadh, SAU.
³ Department of Pathology & Laboratory Medicine, King Abdulaziz Medical City - National Guards Health Affairs, Riyadh, SAU.
⁴ Department of Infectious Diseases, King Abdullah International Medical Research Center, Riyadh, SAU.

Abstract

Background Methicillin-resistant Staphylococcus aureus (MRSA) has become increasingly common in hospitals worldwide. In an era of pandemics, it is important to understand all types of infectious diseases in order to control its outcome and reduce mortality rates related to it. This study aims to identify the epidemiology of MRSA bloodstream infection, risk factors, and mortality in King Abdulaziz Medical City in Riyadh. Methods This is a retrospective chart review study from January 2013 to June 2017. All patients with positive blood culture for MRSA at King Abdulaziz Medical City (KAMC), which is a tertiary care center in Riyadh, Saudi Arabia, were included. Data were extracted from electronic and paper medical records for patients who had a positive blood culture for MRSA. Data collected included demographics, microbiological details, risk factors, and 30-day mortality. Results From 2013 through June 2017, 633 Staphylococcus aureus bacteremia were reported in KAMC, of which 184 (29.1%) were MRSA with a mean age of 60±19 years. Almost all of our isolates were susceptible to vancomycin, linezolid, and tigecycline. The most common infectious syndrome these patients presented with was an endovascular infection which accounts for 30.4% while 19.9% presented as a case of pneumonia. The mortality within 30 days of collection of the positive blood culture was 20.65%. Male gender (OR = 2.33; 95% CI = 1.34-4.05; P-value = 0.003) and patients with history of recent hospital (OR = 2.34; 95% CI = 1.27-4.34; P-value = 0.007) or ICU (OR = 1.66; 95% CI = 1.09-2.52; P-value = 0.018) admissions were more likely to acquire MRSA. Conclusions The incidence of MRSA bacteremia at King Abdulaziz Medical City is high and increasing in conjunction with incidence rate posing a significantly high rate of mortality. Recent history of hospital admission, ICU admission and males were found to be significantly associated with higher rates of MRSA infection. Some modifiable risk factors that could be used to facilitate the reduction of MRSA acquisition rates is to avoid unnecessary hospital and ICU admissions.

Keywords: bacteremia; incidence; methicillin resistant staphylococcus aureus (mrsa); methicillin resistant staphylococcus aureus bacteremia; mortality; risk factors.