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Table 2 Comparison of clinical and echocardiographic findings between MRSA versus MSSA endocarditis (bivariate analysis)

From: Clinical and prognostic differences between methicillin-resistant and methicillin-susceptible Staphylococcus aureus infective endocarditis

 

MSSA IE N = 378

MRSA IE N = 59

p*

Findings < 1 week before hospitalization, n (%)

212/355 (59.7)

22/52 (42.3)

0.051

Clinical n (%)

- Fever

365(96.6)

55(93.2)

0.251

 - Dyspnea

174(46)

31(52.5)

0.361

 - Constitutional syndrome

81(21.4)

11(18.6)

0.689

 - Murmur

199(52.6)

30(50.8)

0.822

 - Hepatomegaly

66(17.4)

8(13.6)

0.420

 - Splenomegaly

48(12.7)

9(15.3)

0.615

 - CNS

156(41.3)

18(30.5)

0.116

  Encephalopathy

76 (20.1)

9 (15.3)

0.4

  Meningitis

20 (5.3)

1 (1.69)

0.3

  Abscess

6 (1.6)

0

1

  Embolic non-hemorrhagic stroke

62 (16.4)

7 (11.9)

0.43

  Embolic hemorrhagic stroke

11 (2.9)

2 (3.39)

0.68

  Hemorrhagic stroke with no previous Embolism

22 (5.8)

2 (3.39)

0.75

 - Renal embolism

6(1.6)

0

1

 - Spleen embolism

22(5.8)

5(8.5)

0.387

 - Large vessel embolism

30(7.9)

5(8.5)

0.799

 - Pulmonary embolism

27(7.1)

8(13.6)

0.119

 - Roth’s spots

13 (3.4)

0

0.228

 - Conjunctival hemorrhage

15(3.9)

0

0.230

 - Endophthalmitis

0

1 (1.7)

0.127

 - Cutaneous manifestation

108 (28.6)

11 (18.6)

0.093

 - Petechiae

80 (21.2)

7 (11.9)

0.115

 - Janeway lesions

53(14)

3(5.1)

0.054

 - Osler’s nodes

61(16.1)

4(6.8)

0.057

 - Splinter hemorrhage

43(11.4)

5(8.5)

0.496

 - Duke vascular or embolic phenomena

120(31.7)

12(20.4)

0.072

 - Duke immunological phenomena

29 (7.7)

1 (1.7)

0.099

 - Osteoarticular involvement

52(13.8)

8(13.6)

0.98

 - Acute kidney failure during hospitalization

159(42)

22(37.3)

0.469

 - Heart failure

171 (45.2)

25(42.4)

0.643

  Grade III-IV

90 (23.8)

18 (30.5)

0.3

 - Severe sepsis/Septic shock

97(25.7)

14(23.7)

0.751

 - Acute pulmonary edema

93(24.6)

17(28.8)

0.446

Echocardiographic findings, n (%) **

 - Diagnostic data

336 (88.9)

49(83.1)

0.34

 - Vegetation

249(65.9)

43 (72.9)

0.615

 - Perivalvular lesion

107(28.3)

9(15.3)

0.043

 - Pseudoaneurysm

14(3.7)

1(1.7)

0.7

 - Fistula in valvular system

8(2.1)

2(3.4)

0.63

 - Valvular system rupture or perforation

63(16.7)

6(10.2)

0.226

 - Prosthesis dehiscence or dysfunction

23(6.1)

5(8.5)

0.39

 - Pericardial effusion

14(3.7)

2(4.4)

1

IE classification, n(%)

 Possible

25 (6.6)

7(11.9)

 

 Definite

352(93.1)

52(88.1)

0.18

  1. (**) Transthoracic Echocardiogram was obtained in 94.9% of patients with MRSA IE and transesophageal echocardiogram in 54.2%. Transthoracic echocardiogram was obtained in 96.3% of patients with MSSA IE and transesophageal echocardiogram in 56.3%