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Nosocomial bloodstream infection in patients caused by Staphylococcus aureus: drug susceptibility, outcome, and risk factors for hospital mortality.
Chin Med J (Engl). 2012 Jan; 125(2):226-9.CM

Abstract

BACKGROUND

Previous studies have different viewpoints about the clinical impact of methicillin resistance on mortality of hospital-acquired bloodstream infection (BSI) patients with Staphylococcus aureus (S. aureus). The objective of this study was to investigate the mortality of hospital-acquired BSI with S. aureus in a military hospital and analyze the risk factors for the hospital mortality.

METHODS

A retrospective cohort study was performed in patients admitted to the biggest military tertiary teaching hospital in China between January 2006 and May 2011. All included patients had clinically significant nosocomial BSI with S. aureus. Multivariate Logistic regression analysis was used to identify the risk factors for hospital mortality of patients with S. aureus BSI.

RESULTS

One hundred and eighteen patients of more than one year old were identified as clinically and microbiologically confirmed nosocomial bacteraemia due to S. aureus, and 75 out of 118 patients were infected with methicillin-resistant S. aureus (MRSA). The overall mortality of nosocomial S. aureus BSI was 28.0%. Methicillin resistance in S. aureus bacteremia was associated with significant increase in the length of hospitalization and high proportion of inappropriate empirical antibiotic treatment. After Logistic regression analysis, the severity of clinical manifestations (APACHE II score) (odds ratio (OR) 1.22, 95% confidence interval (CI) 1.12 - 1.34) and inadequacy of empirical antimicrobial therapy (OR 0.25, 95%CI 0.09 - 0.69) remained as risk factors for hospital mortality.

CONCLUSIONS

Nosocomial S. aureus BSI was associated with high in-hospital mortality. Methicillin resistance in S. aureus has no significant impact on the outcome of patients with staphylococcal bacteremia. Proper empirical antimicrobial therapy is very important to the prognosis.

Authors+Show Affiliations

Department of Microbiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22340550

Citation

Chen, Rong, et al. "Nosocomial Bloodstream Infection in Patients Caused By Staphylococcus Aureus: Drug Susceptibility, Outcome, and Risk Factors for Hospital Mortality." Chinese Medical Journal, vol. 125, no. 2, 2012, pp. 226-9.
Chen R, Yan ZQ, Feng D, et al. Nosocomial bloodstream infection in patients caused by Staphylococcus aureus: drug susceptibility, outcome, and risk factors for hospital mortality. Chin Med J. 2012;125(2):226-9.
Chen, R., Yan, Z. Q., Feng, D., Luo, Y. P., Wang, L. L., & Shen, D. X. (2012). Nosocomial bloodstream infection in patients caused by Staphylococcus aureus: drug susceptibility, outcome, and risk factors for hospital mortality. Chinese Medical Journal, 125(2), 226-9.
Chen R, et al. Nosocomial Bloodstream Infection in Patients Caused By Staphylococcus Aureus: Drug Susceptibility, Outcome, and Risk Factors for Hospital Mortality. Chin Med J. 2012;125(2):226-9. PubMed PMID: 22340550.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nosocomial bloodstream infection in patients caused by Staphylococcus aureus: drug susceptibility, outcome, and risk factors for hospital mortality. AU - Chen,Rong, AU - Yan,Zhong-Qiang, AU - Feng,Dan, AU - Luo,Yan-Ping, AU - Wang,Lei-Li, AU - Shen,Ding-Xia, PY - 2012/2/21/entrez PY - 2012/2/22/pubmed PY - 2012/7/11/medline SP - 226 EP - 9 JF - Chinese medical journal JO - Chin. Med. J. VL - 125 IS - 2 N2 - BACKGROUND: Previous studies have different viewpoints about the clinical impact of methicillin resistance on mortality of hospital-acquired bloodstream infection (BSI) patients with Staphylococcus aureus (S. aureus). The objective of this study was to investigate the mortality of hospital-acquired BSI with S. aureus in a military hospital and analyze the risk factors for the hospital mortality. METHODS: A retrospective cohort study was performed in patients admitted to the biggest military tertiary teaching hospital in China between January 2006 and May 2011. All included patients had clinically significant nosocomial BSI with S. aureus. Multivariate Logistic regression analysis was used to identify the risk factors for hospital mortality of patients with S. aureus BSI. RESULTS: One hundred and eighteen patients of more than one year old were identified as clinically and microbiologically confirmed nosocomial bacteraemia due to S. aureus, and 75 out of 118 patients were infected with methicillin-resistant S. aureus (MRSA). The overall mortality of nosocomial S. aureus BSI was 28.0%. Methicillin resistance in S. aureus bacteremia was associated with significant increase in the length of hospitalization and high proportion of inappropriate empirical antibiotic treatment. After Logistic regression analysis, the severity of clinical manifestations (APACHE II score) (odds ratio (OR) 1.22, 95% confidence interval (CI) 1.12 - 1.34) and inadequacy of empirical antimicrobial therapy (OR 0.25, 95%CI 0.09 - 0.69) remained as risk factors for hospital mortality. CONCLUSIONS: Nosocomial S. aureus BSI was associated with high in-hospital mortality. Methicillin resistance in S. aureus has no significant impact on the outcome of patients with staphylococcal bacteremia. Proper empirical antimicrobial therapy is very important to the prognosis. SN - 2542-5641 UR - https://www.unboundmedicine.com/medline/citation/22340550/Nosocomial_bloodstream_infection_in_patients_caused_by_Staphylococcus_aureus:_drug_susceptibility_outcome_and_risk_factors_for_hospital_mortality_ L2 - http://Insights.ovid.com/pubmed?pmid=22340550 DB - PRIME DP - Unbound Medicine ER -