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[Bacteremia by Staphylococcus aureus: analysis of 311 episodes].
Enferm Infecc Microbiol Clin 1999; 17(2):56-64EI

Abstract

BACKGROUND

The aim of this study was to set up the differences between nosocomial and community acquired S. aureus bacteremia, to identify the features of the patients at high risk of endocarditis and to define the characteristics of the patients with methicillin resistant S. aureus (MRSA).

METHODS

We prospectively studied 311 cases of S. aureus bacteremia detected at our hospital during a four-year period.

RESULTS

Nosocomial acquisition of bacteremia was found in 63% of the cases, 45% of which were caused by MRSA. Nosocomial bacteria generally presented in older patients with more severe underlying conditions and a higher prevalence of invasive procedures than patients with the community-acquired disease. Likewise, the primary focus of infection was identifiable in most of the nosocomial episodes and mortality was also higher. Endocarditis presented in 19% of the bacteremia episodes and almost 90% of patients with endocarditis were intravenous drug users (IDU). The risk of endocarditis in this group was 64% whereas it was only 3% in non-IDU patients. Overall mortality was 33% and mortality directly due to the bacteremia was 22%.

CONCLUSIONS

IDU patients were at high risk of endocarditis but most had a favourable outcome. Bacteremia was community-acquired in these patients and they rarely presented MRSA bacteremia. Patients with previous valvular diseases were at high risk of endocarditis and had a high mortality. Non-IDU patients with community-acquired bacteremia were at a low risk of endocarditis, regardless of whether a primary focus of infection had been identified or not. Mortality was lower in this group than in patients with nosocomial bacteremia and there were no cases of MRSA bacteremia. Mortality was higher in patients treated with vancomycin than in patients treated with other antibiotics active against S. aureus.

Authors+Show Affiliations

Departamento de Especialidades Médicas, Facultad de Ciencias de la Salud, Universidad Europea de Madrid. margarita.rubio@ema.cisa.uem.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

spa

PubMed ID

10193063

Citation

Rubio, M, et al. "[Bacteremia By Staphylococcus Aureus: Analysis of 311 Episodes]." Enfermedades Infecciosas Y Microbiologia Clinica, vol. 17, no. 2, 1999, pp. 56-64.
Rubio M, Romero J, Corral O, et al. [Bacteremia by Staphylococcus aureus: analysis of 311 episodes]. Enferm Infecc Microbiol Clin. 1999;17(2):56-64.
Rubio, M., Romero, J., Corral, O., Roca, V., & Picazo, J. J. (1999). [Bacteremia by Staphylococcus aureus: analysis of 311 episodes]. Enfermedades Infecciosas Y Microbiologia Clinica, 17(2), pp. 56-64.
Rubio M, et al. [Bacteremia By Staphylococcus Aureus: Analysis of 311 Episodes]. Enferm Infecc Microbiol Clin. 1999;17(2):56-64. PubMed PMID: 10193063.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Bacteremia by Staphylococcus aureus: analysis of 311 episodes]. AU - Rubio,M, AU - Romero,J, AU - Corral,O, AU - Roca,V, AU - Picazo,J J, PY - 1999/4/8/pubmed PY - 1999/4/8/medline PY - 1999/4/8/entrez SP - 56 EP - 64 JF - Enfermedades infecciosas y microbiologia clinica JO - Enferm. Infecc. Microbiol. Clin. VL - 17 IS - 2 N2 - BACKGROUND: The aim of this study was to set up the differences between nosocomial and community acquired S. aureus bacteremia, to identify the features of the patients at high risk of endocarditis and to define the characteristics of the patients with methicillin resistant S. aureus (MRSA). METHODS: We prospectively studied 311 cases of S. aureus bacteremia detected at our hospital during a four-year period. RESULTS: Nosocomial acquisition of bacteremia was found in 63% of the cases, 45% of which were caused by MRSA. Nosocomial bacteria generally presented in older patients with more severe underlying conditions and a higher prevalence of invasive procedures than patients with the community-acquired disease. Likewise, the primary focus of infection was identifiable in most of the nosocomial episodes and mortality was also higher. Endocarditis presented in 19% of the bacteremia episodes and almost 90% of patients with endocarditis were intravenous drug users (IDU). The risk of endocarditis in this group was 64% whereas it was only 3% in non-IDU patients. Overall mortality was 33% and mortality directly due to the bacteremia was 22%. CONCLUSIONS: IDU patients were at high risk of endocarditis but most had a favourable outcome. Bacteremia was community-acquired in these patients and they rarely presented MRSA bacteremia. Patients with previous valvular diseases were at high risk of endocarditis and had a high mortality. Non-IDU patients with community-acquired bacteremia were at a low risk of endocarditis, regardless of whether a primary focus of infection had been identified or not. Mortality was lower in this group than in patients with nosocomial bacteremia and there were no cases of MRSA bacteremia. Mortality was higher in patients treated with vancomycin than in patients treated with other antibiotics active against S. aureus. SN - 0213-005X UR - https://www.unboundmedicine.com/medline/citation/10193063/[Bacteremia_by_Staphylococcus_aureus:_analysis_of_311_episodes]_ L2 - https://medlineplus.gov/staphylococcalinfections.html DB - PRIME DP - Unbound Medicine ER -