Prognostic significance of early platelet dynamics in Staphylococcus aureus bacteremia

BMC Infectious Diseases

Research

Rachid Douglas-Louis¹  Brian Lee¹  Mimi Lou¹  Annie Wong-Beringer²  Emi Minejima³  Juliane Bubeck-Wardenburg⁴ 

[1] Department of Clinical Pharmacy, University of Southern California (USC) Alfred E. Mann School of Pharmacy, 1985 Zonal Ave, 90089, Los Angeles, CA, USA;Department of Clinical Pharmacy, University of Southern California (USC) Alfred E. Mann School of Pharmacy, 1985 Zonal Ave, 90089, Los Angeles, CA, USA;Department of Pharmacy, Huntington Memorial Hospital, Pasadena, CA, USA;Department of Clinical Pharmacy, University of Southern California (USC) Alfred E. Mann School of Pharmacy, 1985 Zonal Ave, 90089, Los Angeles, CA, USA;Los Angeles County and USC Medical Center, Los Angeles, CA, USA;Department of Pediatrics and Division of Pediatric Critical Care Medicine, Washington University School of Medicine, St. Louis, MO, USA;

关键词: Staphylococcus aureus;    Bacteremia;    Thrombocytopenia;    Mortality;   

DOI  :  10.1186/s12879-023-08046-w

 received in 2022-09-30, accepted in 2023-01-30,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPlatelets are recognized as key immune effectors, but they are targets of bacterial virulence factors. In the present study, we aimed to examine the relationship between early platelet dynamics and the outcome of Staphylococcus aureus bacteremia (SAB).MethodElectronic medical records of adult patients hospitalized for SAB between July 2012 and November 2020 were retrospectively reviewed for relevant demographic, laboratory, and clinical data. The outcome endpoints were mortality and microbial persistence.ResultsAmong the 811 patients evaluated, 29% experienced thrombocytopenia on Day 1. Platelet count nadir occurred on Days 2–3 following SAB onset, and Day 4 was a determining point of platelet count trajectory and mortality. Mortality risk was 6% or less for those with normal platelet count by Day 4 regardless of whether they experienced thrombocytopenia on Day 1, but the risk increased to 16–21% for those who experienced thrombocytopenia on Day 4 regardless of whether they had normal platelet count on Day 1 or sustained thrombocytopenia. The duration of bacteremia was prolonged by one day (median 3 d vs. 2 d) for those with sustained thrombocytopenia compared to those without.ConclusionEarly platelet dynamics during SAB have prognostic significance and represent an early window for potential platelet-directed therapeutic interventions to improve outcome.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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