The Case Fatality Rate of Methicillin-Resistant Staphylococcus aureus (MRSA) Infection among the Elderly in a Geriatric Hospital and Their Risk Factors
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MASAKAZU WASHIO, CHIKAKO KIYOHARA,1 TADASHI HAMADA, YOSHIHIRO MIYAKE,1 YUMIKO ARAI2 and MASAHIRO OKAYAMA
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Imazu Red Cross Hospital, Fukuoka 817, 1Department of Public Health, School of Medicine, Kyushu University, Fukuoka 812-82, and 2Department of Public Health, Tohoku University School of Medicine, Sendai 980-77
From April 1991 to March 1993, there were 49 elderly patients with methicillin-resistant Staphylococcus aureus (MRSA) infection in a geriatric hospital in Fukuoka, Japan. The retrospective study was carried out in order to evaluate the various factors which may influence the case fatality rate of MRSA infection among the elderly. Among them, 33 patients (67.3%) died while only 16 patients became culture-negative for MRSA and discharged after recovering from MRSA infection. A univariate analysis revealed that male sex (odds ratio [OR] = 12.25, 95% confidence interval [CI] = 2.80-53.55), hypoalbuminemia (OR = 3.83, 95% CI = 1.11-13.21) and an excessive usage of antibiotics (OR = 6.67, 95% CI = 1.70-26.09) were risk factors for death among the patients with MRSA infection. In a multivariate analysis, male sex and an excessive usage of antibiotics were still risk facters while hypoalbuminemia was not. However, hypoalbuminemina was more common in male patients than female patients (78.3% vs. 42.3%, p < 0.05). These findings suggest that the case fatality rate of MRSA infection may be high and also suggest that the elderly with MRSA infection who had hypoalbuminemia and/or received many antibiotics may have a poor prognosis.
Key words---
MRSA; case fatality rate; antibiotics; hypoalbuminemia; elderly
© 1997 Tohoku University Medical Press
Tohoku J. Exp. Med., 1997, 183, 75-82
Address for reprints:
Masakazu Washio, M.D., PhD., Department of Public Health, School of Medicine, Kyushu University, Fukuoka 812-82, Japan.
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