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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...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
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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. |
format | Online Article Text |
id | pubmed-5289427 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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