ICU patients with MRSA infection may face 50% increased risk of death

Does the Methicillin-resistant Staphylococcus aureus, MRSA, cause more deaths in hospitals than the bacteria that are sensitive to common antibiotics? Opinions have been varied, but now a worldwide study at, among others, Linköping University in Sweden, indicates that the mortality rate can be 50 % higher for intensive care patients infected with MRSA.

Golden staph (Staphylococcus aureus) is a common cause of infections in patients in intensive care and in many countries often methicillin-resistant, i.e. it is resistant to most staphylococcus antibiotics. Only a few, very expensive antibiotics remain and they produce challenging side effects. The infection is easily transmitted in hospital settings where many patients are especially vulnerable to infection.

However whether or not MRSA retains an increased mortality rate in patients has been a controversial point. Now, Håkan Hanberger, Professor of Infectious Diseases at Linköping University, has published a study conducted in 75 countries that delivers an unequivocal result: Intensive care patients who received treatment for an infection caused by golden staph 50 % increased risk for fatality if the bacterium is resistant.

"The study also shows that every second staph was resistant to the golden staph penicillin which remains the standard treatment in the Swedish health care," says Håkan Hanberger.

Hanberger is principal author of the article published in the International Journal of Antimicrobial Agents, and is now available on the journal's Web edition.

The study, entitled EPIC II, was conducted

• On May 8, 2007
• At 1265 intensive care units
• In 75 countries on all continents
• On 13,796 hospitalized patients.

Over half of the patients had some kind of infection: 999 patients were infected with Staphylococcus aureus including 494 with MRSA. The subjects were reassessed 60 days later.

Patients infected with MRSA were slightly older than the others in the group and to a greater extent, suffered from cancer and chronic renal failure. However once the results were adjusted for these and other factors in the so-called multivariate analysis, it became evident that infections with resistant staphylococci accounted for nearly a 50% increase in mortality.

There was considerable variation among patients from different geographical regions.

"In Sweden, the incidence of MRSA remains low, less than 5%. Therefore it is very important that patients infected with staphylococci are isolated and screened in order to prevent the spread of the disease," says Håkan Hanberger.