Community-associated methicillin-resistant Staphylococcus aureus endocarditis ‘down under’: Case series and literature review

Abstract

Infective endocarditis is a common complication of Staphylococcus aureus bacteraemia, but literature reports of community-associated methicillin-resistant S. aureus (CA-MRSA) endocarditis are relatively uncommon and mostly comprise intravenous drug users (IVDUs) with the USA300 strain. We report 5 cases of CA-MRSA endocarditis in previously healthy young Australian adults, 4 in IVDUs. Morbidity was high with frequent septic emboli; 3 patients required cardiac surgery and 1 patient died. Typing revealed the 2 most common Australian strains, the Panton–Valentine leukocidin (PVL)-positive ST93 (Queensland) strain and the PVL-negative ST1 (WA-MRSA-1) strain.

Keywords::

• Endocarditis
• Staphylococcus aureus
• methicillin resistance
• community-associated
• vancomycin

Acknowledgements

We thank Haakon Bergh, Supervising Scientist at Pathology Queensland for performing SNP typing and PVL PCR on the isolates.

Declaration of interest: This study was unfunded. All authors report no conflicts of interest.