Delayed peripheral venous catheter-related Staphylococcus aureus bacteremia: onset ≥ 24 hours after catheter removal

Scand J Infect Dis. 2012 Jul;44(7):551-4. doi: 10.3109/00365548.2012.669841. Epub 2012 Apr 12.

Abstract

Peripheral venous catheter (PVC)-associated bacteremia usually develops during the indwelling period. We present a review of 14 patients who developed delayed onset Staphylococcus aureus bacteremia (D-SAB), 1-6 days after PVC removal, and compare them to 29 patients with early onset PVC-related S. aureus bacteremia (E-SAB). At the time of removal, the catheter site exhibited inflammation in 8 (57.1%) cases. At SAB onset, PVC site inflammation developed in all patients. Compared to E-SAB, patients with D-SAB were more often aged ≥ 65 y (71.4% vs. 34.5%; p = 0.03) and on corticosteroids (35.7% vs. 6.9%; p = 0.02). D-SAB was more complicated with persistent (> 3 days) bacteremia (42.9% vs. 13.8%; p = 0.04), metastatic infections (35.7% vs. 6.9%; p = 0.02), and slightly higher mortality (21.4% vs. 10.3%; p = 0.3). Logistic regression revealed that the predictors of D-SAB were corticosteroids (odds ratio (OR) 2.10, 95% confidence intervals (CI) 1.16-58.61) and age ≥ 65 y (OR 1.63, 95% CI 1.12-23.30). These patients may have impaired local/systemic defenses that lead to D-SAB, or a blunted host response with delayed recognition.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteremia / diagnosis*
  • Bacteremia / microbiology*
  • Catheter-Related Infections / diagnosis*
  • Catheter-Related Infections / microbiology*
  • Catheterization / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Staphylococcal Infections / diagnosis*
  • Staphylococcal Infections / microbiology*
  • Staphylococcus aureus / isolation & purification*
  • Time Factors