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We read with interest the retrospective cohort analysis by Mary-Claire Roghmann¹ discussing the clinical predictors of bacteremia with methicillin-resistant Staphylococcus aureus (MRSA) and the impact of inadequate initial empiric therapy on survival. This study indicated that the strongest predictor for MRSA bacteremia was prior colonization or infection with MRSA, with a relative risk of 4.1. In light of this increased risk, we wish to highlight 2 cases of S aureus bacteremia seen at our institution over the past year, which demonstrate that patients with a prior MRSA infection (particularly bacteremia) may deserve special management considerations.

REPORT OF CASES

Case 1

A 61-year-old man with type 1 diabetes mellitus and a cadaveric kidney transplant was admitted with fevers, chills, chest pain, and acute-on-chronic left shoulder pain in August 1999. He had a history of MRSA bacteremia in May 1999 in the setting of mediastinitis after coronary artery bypass grafting for which he underwent debridement and a . . . [Full Text of this Article]

Case 2

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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Methicillin-Resistant Staphylococcus aureus: Comparison of Susceptibility Testing Methods and Analysis of mecA-Positive Susceptible Strains
Sakoulas et al.
J. Clin. Microbiol. 2001;39:3946-3951.
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