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J Infect. 2014 Mar;68(3):242-51. doi: 10.1016/j.jinf.2013.10.015. Epub 2013 Nov 16.

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

Author information

1
Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Germany. Electronic address: achim.kaasch@uk-koeln.de.
2
Department of Infection and Tropical Medicine, Hull and East Yorkshire Hospitals NHS Trust, Hull, United Kingdom.
3
Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Kings College London & Guy's and St. Thomas' Hospitals NHS Foundation Trust, London, United Kingdom.
4
Department of Medicine, Duke University, Durham, NC, USA.
5
Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Germany.
6
Department of Infectious Diseases and Microbiology, Royal Free London NHS Foundation Trust, London, United Kingdom.
7
Center for Infectious Diseases and Travel Medicine, Department of Medicine, University Hospital of Freiburg, Germany.
8
Department of Infectious Diseases and Microbiology, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom.
9
Infectious Diseases and Clinical Microbiology Unit, Hospital Universitario Virgen Macarena; Department of Medicine, University of Seville, Seville, Spain.
10
Department of Infectious Diseases, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
11
Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Germany.
12
Service of Infectious Diseases, Hospital Clínic of Barcelona, Barcelona, Spain.
13
Department of Microbiology, Plymouth Hospitals NHS Trust, Plymouth, United Kingdom.
14
Department of Medicine, University of Cambridge, Cambridge, United Kingdom.
15
Department of Microbiology, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
16
Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Kings College London & Guy's and St. Thomas' Hospitals NHS Foundation Trust, London, United Kingdom; Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom.

Erratum in

  • J Infect. 2014 Sep;69(3):306-7.

Abstract

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.

KEYWORDS:

Bacteraemia; Mortality; Pooled analysis; Staphylococcus aureus bloodstream infection

PMID:
24247070
PMCID:
PMC4136490
DOI:
10.1016/j.jinf.2013.10.015
[Indexed for MEDLINE]
Free PMC Article

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