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Clinical and microbiological determinants of outcome in Staphylococcus aureus Bacteraemia

Clinical and microbiological determinants of outcome in Staphylococcus aureus Bacteraemia
Clinical and microbiological determinants of outcome in Staphylococcus aureus Bacteraemia
Staphylococcus aureus bacteraemia (SAB) is commonly complicated by metastatic infection or relapse after treatment. Objectives. The study aim was to determine the role of bacterial, host, and management factors in development of complicated SAB. Methods. A prospectively-conducted observational study gathered data on predisposition, management and outcome of 100 consecutive SAB cases. Antibiotic susceptibilities and genetic lineage of bacterial isolates were determined. Further clinical and microbiological data were gathered on two retrospective series from 1999–2000 () and 2004 (). Results. In the prospective cases, 27% met our definition of complicated disease. Expressed as RR and 95% CI, complicated disease was associated with diabetes (1.58, 1.00–2.48), injecting-drug use (5.48, 0.88–33.49), community-onset of symptoms (1.4, 1.02–1.92), and symptom duration hours prior to starting effective antibiotic therapy (2.10, 1.22–3.61). Uncomplicated disease was associated with the presence of a central line (0.69, 0.55–0.88) and prompt removal of a primary focus (0.71, 0.57–0.90). Neither methicillin resistance nor genetic lineage was associated with complicated disease, but methicillin resistance was associated with higher mortality. Conclusions. This study demonstrates that clinical rather than microbial factors are the major determinants of SAB outcome and underscores the importance of early treatment.
1687-918X
654858-[7pp]
Price, J.
5649fe7d-4769-42aa-b6ea-06662c7e3ea4
Baker, G.
bb6c012b-10bd-4c95-81e2-d7906be27156
Heath, I.
55a961e3-1df2-471c-adac-23fb2174a47a
Walker-Bone, K.
ad7d1336-ed2c-4f39-ade5-da84eb412109
Cubbon, M.
df4e2435-c6ee-4bd0-aba1-1578722e1971
Curtis, S.
16ee1200-f5f8-4d48-9e37-01c893e767bf
Enright, M.C.
dd50ce4f-2b77-4ac6-83b3-917f57e39f87
Lindsay, J.
f2b1b13f-be37-4e2b-bc3e-206c49bab208
Paul, J.
fb875029-2055-41f1-a8a6-db8cfa05f5e9
Llewelyn, M.
b1363a98-5f8e-4007-9525-312dcf0a8a9a
Price, J.
5649fe7d-4769-42aa-b6ea-06662c7e3ea4
Baker, G.
bb6c012b-10bd-4c95-81e2-d7906be27156
Heath, I.
55a961e3-1df2-471c-adac-23fb2174a47a
Walker-Bone, K.
ad7d1336-ed2c-4f39-ade5-da84eb412109
Cubbon, M.
df4e2435-c6ee-4bd0-aba1-1578722e1971
Curtis, S.
16ee1200-f5f8-4d48-9e37-01c893e767bf
Enright, M.C.
dd50ce4f-2b77-4ac6-83b3-917f57e39f87
Lindsay, J.
f2b1b13f-be37-4e2b-bc3e-206c49bab208
Paul, J.
fb875029-2055-41f1-a8a6-db8cfa05f5e9
Llewelyn, M.
b1363a98-5f8e-4007-9525-312dcf0a8a9a

Price, J., Baker, G., Heath, I., Walker-Bone, K., Cubbon, M., Curtis, S., Enright, M.C., Lindsay, J., Paul, J. and Llewelyn, M. (2010) Clinical and microbiological determinants of outcome in Staphylococcus aureus Bacteraemia. International Journal of Microbiology, 2010, 654858-[7pp]. (doi:10.1155/2010/654858). (PMID:20300477)

Record type: Article

Abstract

Staphylococcus aureus bacteraemia (SAB) is commonly complicated by metastatic infection or relapse after treatment. Objectives. The study aim was to determine the role of bacterial, host, and management factors in development of complicated SAB. Methods. A prospectively-conducted observational study gathered data on predisposition, management and outcome of 100 consecutive SAB cases. Antibiotic susceptibilities and genetic lineage of bacterial isolates were determined. Further clinical and microbiological data were gathered on two retrospective series from 1999–2000 () and 2004 (). Results. In the prospective cases, 27% met our definition of complicated disease. Expressed as RR and 95% CI, complicated disease was associated with diabetes (1.58, 1.00–2.48), injecting-drug use (5.48, 0.88–33.49), community-onset of symptoms (1.4, 1.02–1.92), and symptom duration hours prior to starting effective antibiotic therapy (2.10, 1.22–3.61). Uncomplicated disease was associated with the presence of a central line (0.69, 0.55–0.88) and prompt removal of a primary focus (0.71, 0.57–0.90). Neither methicillin resistance nor genetic lineage was associated with complicated disease, but methicillin resistance was associated with higher mortality. Conclusions. This study demonstrates that clinical rather than microbial factors are the major determinants of SAB outcome and underscores the importance of early treatment.

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e-pub ahead of print date: 16 March 2010
Organisations: Human Development & Health

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Local EPrints ID: 357064
URI: http://eprints.soton.ac.uk/id/eprint/357064
ISSN: 1687-918X
PURE UUID: f5001c0a-7c1e-45b4-825f-8bae7a98ee4e
ORCID for K. Walker-Bone: ORCID iD orcid.org/0000-0002-5992-1459

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Date deposited: 01 Oct 2013 15:49
Last modified: 15 Mar 2024 03:04

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Contributors

Author: J. Price
Author: G. Baker
Author: I. Heath
Author: K. Walker-Bone ORCID iD
Author: M. Cubbon
Author: S. Curtis
Author: M.C. Enright
Author: J. Lindsay
Author: J. Paul
Author: M. Llewelyn

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