The Effect of Staphylococcal Cassette Chromosome mec (SCCmec) Type on Clinical Outcomes in Methicillin-Resistant Staphylococcus aureus Bacteremia ; J Infect

Objectives ; The impact of staphylococcal cassette chromosome mec (SCCmec) type on mortality in methicillin-resistant Staphylococcus aureus (MRSA) infections remains unclear. The objective of this study was to determine the association between SCCmec type and mortality in MRSA bacteremia. ; Methods ; A cohort study of patients who were hospitalized with MRSA bacteremia was conducted within a university health system. A multivariable logistic regression model was developed to evaluate the association of SCCmec type with 30-day in-hospital mortality. ; Results ; Thirty-four of a total of 184 patients with MRSA bacteremia died, resulting in a mortality rate of 18.5%. Adjusted risk factors for 30-day mortality included APRDRG Risk of Mortality score (odds ratio [OR], 5.33; 95% confidence interval [CI], 2.28-12.4; P<0.001), white blood cell count (OR, 1.09; 95% CI, 1.03-1.15; P=0.002), and malignancy (OR, 3.25; 95% CI, 1.17-9.02; P=0.02). On multivariable analyses, SCCmec II was not significantly associated with mortality in patients with MRSA bacteremia (OR, 1.85; 95% CI, 0.69-4.92; P=0.22). ; Conclusions ; Mortality in MRSA bacteremia was independent of SCCmec type. SCCmec type II is most likely a marker for disease severity rather than a direct mediator of mortality. Further research is needed to elucidate the factors associated with poor clinical outcomes in MRSA infections. ; K24 AI080942/AI/NIAID NIH HHS/United States ; K24 AI080942/AI/NIAID NIH HHS/United States ; L30 AI101162/AI/NIAID NIH HHS/United States ; U54-CK000163/CK/NCEZID CDC HHS/United States ; 2014-01-01T00:00:00Z ; 22960078 ; PMC3518704