ArticleCommunications medicine2026
Impact of methicillin resistance on mortality in Staphylococcus aureus endocarditis: a systematic review and meta-analysis.
Article in Communications medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
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Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMethicillin-resistant Staphylococcus aureus (MRSA) has emerged as a leading cause of endocarditis with poor outcomes. The magnitude and consistency of its mortality risk compared with methicillin-susceptible S. aureus (MSSA) remain uncertain.
methodsData were extracted from PubMed, Embase, Scopus, and Cochrane Library from database inception to 30 November 2025, without language restrictions. A random-effects model (Restricted Maximum-Likelihood) was used to calculate pooled risk ratios (RRs). Heterogeneity was explored by stratified and meta-regression analyses. Publication bias was assessed using funnel plot symmetry and Egger's regression.
resultsTwenty-four studies, comprising 3291 patients (1,011 with MRSA and 2280 with MSSA), met the inclusion criteria. Pooled short-term mortality was significantly higher in MRSA endocarditis (30.9% vs 25.6%; RR 1.48, 95% CI 1.21-1.80; I² = 34%). Across stratified analyses by study design, setting, region, and study era, mortality remained consistently higher in MRSA endocarditis. No significant differences were found for heart failure (RR 1.08, 95% CI 0.90-1.30), embolic events (RR 0.82, 95% CI 0.51-1.33), stroke (RR 0.88, 95% CI 0.78-1.00), or surgery performed (RR 0.97, 95% CI 0.56-1.68) in MRSA and MSSA groups. No publication bias was revealed by Funnel-plot inspection and Egger's test (p = 0.082). Meta-regression showed no effect modification by age, hospital-acquired infection, prosthetic valve, or right-sided endocarditis.
conclusionsMRSA endocarditis carries a significantly higher short-term mortality than MSSA, consistent across study designs and study-level characteristics. The major complications were comparable between the two groups.
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Registered trials
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