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Abstract
Sir—We agree with Dr. Perencevich that the results from our cohort study [1] suggest that methicillin-resistant Staphylococcus aureus (MRSA) is associated with mortality through the intermediate pathway of shock. This conclusion is presented in the Discussion section of our report [1]. If shock would not have been included in the model predicting mortality, the adjusted OR of death occurring when MRSA was involved would have been 2.48 (95% CI, 1.56–3.95) times the OR for death occurring when methicillin-susceptible Staphylococcus aureus (MSSA) was involved. Inclusion of shock as a predictor of death serves the purpose of providing a quantitative measure of its preeminent effect on mortality, regardless of the cause of shock.