Biography:

Professor Seki has been graduated from Department of Medicine, Nagasaki University, as Medical Doctor, with the specialties including Internal Medicine, Infectious Diseases, and Infection Control. Later on he obtained his post-graduation, started working at Osaka University. After the professor of Tohoku Medical and Pharmaceutical University, presently he has been working at the Saitama Medical University International Medical Center, Hidaka City, Saitama, Japan.

Abstract
Background: Infective endocarditis (IE) caused by MRSA (methicillin-resistant Staphylococcus aureus) is associated with a high mortality rate. This study aimed to elucidate the characteristics of patients with MRSA-IE in Japan and identify the factors associated with prognosis. Methods: This retrospective study included patients with a confirmed diagnosis of IE caused by MRSA, between January 2015 and April 2019. Results: A total of 65 patients from 19 centers were included, with a mean age of 67 years and 26 % were female. Fifty percent of the patients with IE were had nosocomial infections and 25 % had prosthetic valve involvement. The most common comorbidities were hemodialysis (20 %) and diabetes (20 %). Congestive heart failure was present in 86 % of patients (NYHA class I, II: 48 %; III, IV: 38 %). The 30-day and in-hospital mortality rates were 29 % and 46 %, respectively. Multi-organ failure was the primary cause of death, accounting for 43 % of all causes of death. Prognostic factors for in-hospital mortality were age, disseminated intravascular coagulation, daptomycin and/or linezolid as initial antibiotic therapy, and surgery. Surgical treatment was associated with a lower mortality rate (odds ratio [OR], 0.026; 95 % confidence interval [CI], 0.002–0.382; p = 0.008 for 30-day mortality and OR, 0.130; 95 % CI; 0.029–0.584; p = 0.008 for in-hospital mortality). Conclusion: Mortality due to MRSA-IE remains high. Surgical treatment is a significant prognostic predictor of MRSA-IE.