Morbidity from in-hospital complications is greater than treatment failure in patients with Staphylococcus aureus bacteraemia

BMC Infectious Diseases

VANESSA study group, on behalf of the Australasian Society for Infectious Diseases (ASID) Clinical Research Network (CRN)¹  John D. Turnidge²  Allen C. Cheng³  Benjamin P. Howden⁴  Paul D. R. Johnson⁴  Natasha E. Holmes⁴  Tony M. Korman⁵  Eugene Athan⁶  J. Owen Robinson⁷  Sebastiaan J. van Hal⁸  Wendy J. Munckhof⁹ 

[1] ;Australian Commission on Safety and Quality in Health Care;Department of Infectious Diseases, Alfred Hospital;Department of Infectious Diseases, Austin Health, Austin Centre for Infection Research;Department of Infectious Diseases, Monash Health;Department of Infectious Diseases, University Hospital Geelong, Barwon Health;Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine-WA, Royal Perth Hospital;Department of Microbiology and Infectious Diseases, Royal Prince Alfred Hospital;Infection Management Services, Princess Alexandra Hospital;

关键词: Staphylococcus aureus;    Bacteraemia;    Treatment failure;    Complication;    Mortality;   

DOI  :  10.1186/s12879-018-3011-2

来源: DOAJ

【 摘 要 】

Abstract Background Various studies have identified numerous factors associated with poor clinical outcomes in patients with Staphylococcus aureus bacteraemia (SAB). A new study was created to provide deeper insight into in-hospital complications and risk factors for treatment failure. Methods Adult patients hospitalised with Staphylococcus aureus bacteraemia (SAB) were recruited prospectively into a multi-centre cohort. The primary outcome was treatment failure at 30 days (composite of all-cause mortality, persistent bacteraemia, or recurrent bacteraemia), and secondary measures included in-hospital complications and mortality at 6- and 12-months. Data were available for 222 patients recruited from February 2011 to December 2012. Results Treatment failure at 30-days was recorded in 14.4% of patients (30-day mortality 9.5%). Multivariable analysis predictors of treatment failure included age > 70 years, Pitt bacteraemia score ≥ 2, CRP at onset of SAB > 250 mg/L, and persistent fevers after SAB onset; serum albumin at onset of SAB, receipt of appropriate empiric treatment, recent healthcare attendance, and performing echocardiography were protective. 6-month and 12-month mortality were 19.1% and 24.2% respectively. 45% experienced at least one in-hospital complication, including nephrotoxicity in 19.5%. Conclusions This study demonstrates significant improvements in 30-day outcomes in SAB in Australia. However, we have identified important areas to improve outcomes from SAB, particularly reducing renal dysfunction and in-hospital treatment-related complications.

【 授权许可】

Unknown