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Staphylococcus aureus bloodstream infection: a pooled analysis of five prospective, observational studies

journal contribution
posted on 2023-06-08, 18:18 authored by Achim J Kaasch, Gavin Barlow, Jonathan D Edgeworth, Vance G Fowler, Martin Hellmich, Susan Hopkins, Winfried V Kern, Martin LlewelynMartin Llewelyn, Siegbert Rieg, Jesús Rodriguez-Baño, Matthew Scarborough, Harald Seifert, Alex Soriano, Robert Tilley, M Estée Torok, Verena Weiß, A Peter R Wilson, Guy E Thwaites
OBJECTIVES Staphylococcus aureus bacteraemia is a common, often fatal infection. Our aim was to describe how its clinical presentation varies between populations and to identify common determinants of outcome. METHODS We conducted a pooled analysis on 3395 consecutive adult patients with S. aureus bacteraemia. Patients were enrolled between 2006 and 2011 in five prospective studies in 20 tertiary care centres in Germany, Spain, United Kingdom, and United States. RESULTS The median age of participants was 64 years (interquartile range 50-75 years) and 63.8% were male. 25.4% of infections were associated with diabetes mellitus, 40.7% were nosocomial, 20.6% were caused by methicillin-resistant S. aureus (MRSA), although these proportions varied significantly across studies. Intravenous catheters were the commonest identified infective focus (27.7%); 8.3% had endocarditis. Crude 14 and 90-day mortality was 14.6% and 29.2%, respectively. Age, MRSA bacteraemia, nosocomial acquisition, endocarditis, and pneumonia were independently associated with death, but a strong association was with an unidentified infective focus (adjusted hazard ratio for 90-day mortality 2.92; 95% confidence interval 2.33 to 3.67, p < 0.0001). CONCLUSION The baseline demographic and clinical features of S. aureus bacteraemia vary significantly between populations. Mortality could be reduced by assiduous MRSA control and early identification of the infective focus.

History

Publication status

  • Published

File Version

  • Published version

Journal

Journal of Infection

ISSN

0163-4453

Publisher

Elsevier

Issue

3

Volume

68

Page range

242-251

Department affiliated with

  • Global Health and Infection Publications

Full text available

  • No

Peer reviewed?

  • Yes

Legacy Posted Date

2014-09-15

First Compliant Deposit (FCD) Date

2017-01-10

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