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Characteristics of Staphylococcus aureus Bacteraemia and Predictors of Early and Late Mortality

We aimed to describe the characteristics of patients with Staphylococcus aureus bacteremia and to evaluate the risk factors associated with early (7-day) and late (30-day) mortality. We performed an observational study including all consecutive episodes of Staphylococcus aureus bacteremia diagnosed...

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Autores principales: Bassetti, Matteo, Peghin, Maddalena, Trecarichi, Enrico Maria, Carnelutti, Alessia, Righi, Elda, Del Giacomo, Paola, Ansaldi, Filippo, Trucchi, Cecilia, Alicino, Cristiano, Cauda, Roberto, Sartor, Assunta, Spanu, Teresa, Scarparo, Claudio, Tumbarello, Mario
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5289427/
https://www.ncbi.nlm.nih.gov/pubmed/28152067
http://dx.doi.org/10.1371/journal.pone.0170236
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author Bassetti, Matteo
Peghin, Maddalena
Trecarichi, Enrico Maria
Carnelutti, Alessia
Righi, Elda
Del Giacomo, Paola
Ansaldi, Filippo
Trucchi, Cecilia
Alicino, Cristiano
Cauda, Roberto
Sartor, Assunta
Spanu, Teresa
Scarparo, Claudio
Tumbarello, Mario
author_facet Bassetti, Matteo
Peghin, Maddalena
Trecarichi, Enrico Maria
Carnelutti, Alessia
Righi, Elda
Del Giacomo, Paola
Ansaldi, Filippo
Trucchi, Cecilia
Alicino, Cristiano
Cauda, Roberto
Sartor, Assunta
Spanu, Teresa
Scarparo, Claudio
Tumbarello, Mario
author_sort Bassetti, Matteo
collection PubMed
description We aimed to describe the characteristics of patients with Staphylococcus aureus bacteremia and to evaluate the risk factors associated with early (7-day) and late (30-day) mortality. We performed an observational study including all consecutive episodes of Staphylococcus aureus bacteremia diagnosed at two Italian university hospitals during 2010–2014. A total of 337 patients were included. Mean age was 69 years (range, 57–78) and 65% were males. Methicillin-resistant S. aureus (MRSA) was identified in 132/337 (39%)cases. Overall 7- and 30-day mortality were 13% and 26%, respectively. Early mortality was associated with increased Charlson scores (OR 1.3, 95% CI 1.1–1.5), MRSA bacteremia (OR 3.2, 95% CI 1.4–8.1), presentation with septic shock (OR 13.5, 95% CI 5.4–36.4), and occurrence of endocarditis (OR 4.5, 95%CI 1.4–14.6). Similar risk factors were identified for late mortality, including increased Charlson scores (OR 1.2, 95% CI 1.1–1.4), MRSA bacteremia (OR 2.1, 95% CI 1.2–3.9), presentation with septic shock (OR 4, 95%CI 1.7–9.7), occurrence of endocarditis (OR 3.8, 95% CI 1.4–10.2) as well as Child C cirrhosis (OR 3.9, 95% CI 1.1–14.4) and primary bacteremia (OR 2.5, 95%CI 1.3–5). Infectious disease consultation resulted in better outcomes both at 7 (OR 0.1, 95% CI 0.05–0.4) and at 30 days (OR 0.4, 95% CI 0.2–0.7). In conclusion, our study highlighted high rates of MRSA infection in nosocomial Staphylococcus aureus bacteremia. Multiple comorbidities, disease severity and methicillin-resistance are key factors for early and late mortality in this group. In patients with Staphylococcus aureus bacteremia, infectious disease consultation remains a valuable tool to improve clinical outcome.
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spelling pubmed-52894272017-02-17 Characteristics of Staphylococcus aureus Bacteraemia and Predictors of Early and Late Mortality Bassetti, Matteo Peghin, Maddalena Trecarichi, Enrico Maria Carnelutti, Alessia Righi, Elda Del Giacomo, Paola Ansaldi, Filippo Trucchi, Cecilia Alicino, Cristiano Cauda, Roberto Sartor, Assunta Spanu, Teresa Scarparo, Claudio Tumbarello, Mario PLoS One Research Article We aimed to describe the characteristics of patients with Staphylococcus aureus bacteremia and to evaluate the risk factors associated with early (7-day) and late (30-day) mortality. We performed an observational study including all consecutive episodes of Staphylococcus aureus bacteremia diagnosed at two Italian university hospitals during 2010–2014. A total of 337 patients were included. Mean age was 69 years (range, 57–78) and 65% were males. Methicillin-resistant S. aureus (MRSA) was identified in 132/337 (39%)cases. Overall 7- and 30-day mortality were 13% and 26%, respectively. Early mortality was associated with increased Charlson scores (OR 1.3, 95% CI 1.1–1.5), MRSA bacteremia (OR 3.2, 95% CI 1.4–8.1), presentation with septic shock (OR 13.5, 95% CI 5.4–36.4), and occurrence of endocarditis (OR 4.5, 95%CI 1.4–14.6). Similar risk factors were identified for late mortality, including increased Charlson scores (OR 1.2, 95% CI 1.1–1.4), MRSA bacteremia (OR 2.1, 95% CI 1.2–3.9), presentation with septic shock (OR 4, 95%CI 1.7–9.7), occurrence of endocarditis (OR 3.8, 95% CI 1.4–10.2) as well as Child C cirrhosis (OR 3.9, 95% CI 1.1–14.4) and primary bacteremia (OR 2.5, 95%CI 1.3–5). Infectious disease consultation resulted in better outcomes both at 7 (OR 0.1, 95% CI 0.05–0.4) and at 30 days (OR 0.4, 95% CI 0.2–0.7). In conclusion, our study highlighted high rates of MRSA infection in nosocomial Staphylococcus aureus bacteremia. Multiple comorbidities, disease severity and methicillin-resistance are key factors for early and late mortality in this group. In patients with Staphylococcus aureus bacteremia, infectious disease consultation remains a valuable tool to improve clinical outcome. Public Library of Science 2017-02-02 /pmc/articles/PMC5289427/ /pubmed/28152067 http://dx.doi.org/10.1371/journal.pone.0170236 Text en © 2017 Bassetti et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Bassetti, Matteo
Peghin, Maddalena
Trecarichi, Enrico Maria
Carnelutti, Alessia
Righi, Elda
Del Giacomo, Paola
Ansaldi, Filippo
Trucchi, Cecilia
Alicino, Cristiano
Cauda, Roberto
Sartor, Assunta
Spanu, Teresa
Scarparo, Claudio
Tumbarello, Mario
Characteristics of Staphylococcus aureus Bacteraemia and Predictors of Early and Late Mortality
title Characteristics of Staphylococcus aureus Bacteraemia and Predictors of Early and Late Mortality
title_full Characteristics of Staphylococcus aureus Bacteraemia and Predictors of Early and Late Mortality
title_fullStr Characteristics of Staphylococcus aureus Bacteraemia and Predictors of Early and Late Mortality
title_full_unstemmed Characteristics of Staphylococcus aureus Bacteraemia and Predictors of Early and Late Mortality
title_short Characteristics of Staphylococcus aureus Bacteraemia and Predictors of Early and Late Mortality
title_sort characteristics of staphylococcus aureus bacteraemia and predictors of early and late mortality
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5289427/
https://www.ncbi.nlm.nih.gov/pubmed/28152067
http://dx.doi.org/10.1371/journal.pone.0170236
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