Methicillin Sensitive and Resistant Staphylococcus Aureus in Bloodstream Infections: Frequency, Outcome and Cost of Treatment in the Southern Part of Bosnia and Herzegovina

Background: Bloodstream infections (BSI) encountered in hospitals are one of the most complex infections that pose a great challenge. Methicillin-sensitive and Methicillin-resistant Staphylococcus aureus are common causes of severe bloodstreaminfectionsthatareassociatedwithorganfailureandsepticshock.Hence,betterknowledgeoftheincidence ofBSIcausedbyMRSAandMSSAandadequateantibiotictreatmentareimportanttoreducelengthofhospitalstayand improve treatment outcomes.Subjectsandmethods:TheaimofthisstudywastoanalyzethefrequencyofBSIwithMSSAandMRSAinadultpatients whowerehospitalizedatthesametimeandsamedepartmentsoftheUniversityHospitalCentreMostarinthecourseof six years.Results: The incidence of BSI with MSSA and MRSA was shown to be 33,21% and 17,99%, respectively. Averageage of patients infected with MRSA was 61.5 years and with MSSA was 67.5 years. MSSA and MRSA BSI were more commoninmenwithaverageof69,79%and80,77%,respectively.Inbothgroupsofpatients,onethirdhadnoassociated diseases. Patients that had associated chronic disease with mild or moderately severe activity limitations constructed 41,67%withMSSAand46,15%withMRSA.Cardiovasculardiseasesweremostcommonchronicdiseaseinbothgroups, 33.33% for MSSA and 40.38% for MRSA.Treatment of the of subjects with MSSA BSI averaged 15 days and lasted significantlyshorterwhencomparedtoMRSABSItreatmentthataveraged36days.PatientswithMRSABSIweremore treated in middle and/or high-risk departments and with inadequate antibiotic therapy. MRSA BSI patients were more oftenmechanicallyventilated(69,23%),whichcontributestoahighercostoftreatment(averageof8032.5€intotal)and higher drug consumption when compared to the MSSA BSI patients. The death rate was higher in patients treated for MRSA BSI and averaged 67.31%.Conclusions:Theresultsofthisstudyarepromisingsincetheycanbeusedinpracticebycliniciansasaguidelinefor choosing adequate antibiotics, and improve course of treatment, length, outcome and cost.