TABLE 1.
Description of Studies included in Meta-Analysis
| Variable | Seybold et al32 | Carrillo-Marquez et al22 | Kempker et al27 | Kreisel et al10 | Haque et al33 | Lessa et al20 | Tattevin et al34 | Sherwood et al35 |
|---|---|---|---|---|---|---|---|---|
| Study year | 2006 | 2010 | 2010 | 2011 | 2012 | 2012 | 2012 | 2013 |
| Location | Grady Memorial Hospital, Atlanta, GA | Texas Children’s Hospital, Houston, TX | Emerging Infections Program, Atlanta, GA | Baltimore, MD; Buffalo, NY; Washington DC; Richmond, VA | University of Louisville, KY; Ohio State University Medical Center, OH; Henry Ford Health System, MI; University of Miami/Jackson Memorial Hospital, FL; Summa Health System, OH | Active Bacterial Core Surveillance (ABCs) system, CA, CO, GA, MI, NY, TN | San Francisco General Hospital (public, tertiary care) and 13 city-wide outpatient clinics | Walter Reed Army Medical Center and National Naval Medical Center |
| No. of centers | Single | Single | 8 | 4 | 5 | 6 | 14 | 2 |
| Study population | All age groups; MRSA bacteremia | Neonates, infants, children; SA-CRB | All age groups; MRSA bacteremia | Adults, older (≥65 years); MRSA bacteremia | Adults, older (≥65 years); MRSA pneumonia (HAP, VAP, or HCAP) | All age groups; invasive MRSA infection (CLABSI and PNEUMO) | All age groups ≥5 years; MRSA BSI | Adults, older (≥65 years); MRSA BSI |
| Study design | Prospective cohort | Prospective cohort | Prospective cohort | Retrospective cohort | Retrospective cohort | Prospective cohort | Retrospective cohort | Retrospective cohort |
| Comparison group/non-USA300 | USA100, USA500, USA800 | USA100, USA200, USA400, USA700, USA800, unique | USA100, USA500, other (<1%) | One half USA100 | USA100, USA600, other | USA100 | USA100, USA1000, USA500, USA1100, Other (3%) | Predominantly USA100 |
| Staphylococcus aureus typing method | PFGE, SCC mec, PCR for PVL, phenotyping | PFGE, SCCmec, PCR for agr typing and PVL, phenotyping | PFGE | PCR for PVL, ACME, and spa typing, PFGE (used for validation), phenotyping | PFGE, SCCmec, PCR for agr typing and PVL, phenotyping | PFGE | PCR for PVL, ACME, and spa typing, PFGE (used for validation), MLST | PFGE phenotyping |
| No. identified with S. aureus invasive infection | 132a | 112 | 4,344b | 271 | 251 | 336 | 549 | 245c |
| No. (%) with USA300 | 39 (33.6) | 12 (41.4) | 414 (37.5) | 67 (25) | 60 (23.9) | 90 (26.8) | 304 (55.37) | 30 (19.87) |
| No. (%) with non-USA300 | 77 (66.4) | 17 (58.6) | 690 (62.5) | 204 (75) | 191 (76.1) | 246 (73.2) | 245 (44.63) | 121 (80.13) |
| Mortality measured | Crude in-hospital mortality | Crude in-hospital mortality | In-hospital mortality | 90-day mortality | 28-day all-cause mortality | Attributable mortality within 30 days in hospital | Attributable mortality | Crude in-hospital mortality |
| Mortality no./total mortality (%) in invasive infections | ||||||||
| USA300 | 3/25 (12) | 2/5 (40) | 68/204 (33.33) | 20/121 (16.53) | 16 (26.7) | 19/102 (18.63) | 24/47 (51.06) | 5/30 (16.67) |
| Non-USA300 | 22/25 (88) | 3/5 (60) | 136/204 (66.67) | 101/121 (83.47) | 77 (40.3) | 83/102 (81.37) | 23/47 (48.94) | 21/121 (17.35) |
NOTE. ACME, arginine catabolic mobile element; agr, accessory gene regulator; BSI, bloodstream infection; CLABSI, central line-associated bloodstream infection; HAP, hospital-associated pneumonia; HCAP, healthcare-associated pneumonia; MLST, multilocus sequence typing; PCR, polymerase chain reaction; PFGE, pulsed-field gel electrophoresis; phenotyping, antibiotic susceptibility testing; PNEUMO, community-onset pneumonia; PVL, Panton-Valentine leukocidin; SA-CRB, S. aureus catheter-related bacteremia; SCCmec, staphylococcal cassette chromosome mec element; VAP, ventilator-associated pneumonia.
Final analysis included only 116 isolates.
Final analysis included 1,104 isolates typed by PFGE for USA300 vs non-USA300.
Final analysis included only 151 isolates.