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

Holmes, Natasha E., Robinson, J. Owen, van Hal, Sebastiaan J., Munckhof, Wendy J., Athan, Eugene, Korman, Tony M., Cheng, Allen C., Turnidge, John D., Johnson, Paul D. R., Howden, Benjamin P and VANESSA study group, on behalf of the Australasian Society for Infectious Diseases (ASID) Clinical Research Network (CRN) (2018) Morbidity from in-hospital complications is greater than treatment failure in patients with staphylococcus aureus bacteraemia. BMC Infectious Diseases, 18 1: . doi:10.1186/s12879-018-3011-2


Author Holmes, Natasha E.
Robinson, J. Owen
van Hal, Sebastiaan J.
Munckhof, Wendy J.
Athan, Eugene
Korman, Tony M.
Cheng, Allen C.
Turnidge, John D.
Johnson, Paul D. R.
Howden, Benjamin P
VANESSA study group, on behalf of the Australasian Society for Infectious Diseases (ASID) Clinical Research Network (CRN)
Title Morbidity from in-hospital complications is greater than treatment failure in patients with staphylococcus aureus bacteraemia
Journal name BMC Infectious Diseases   Check publisher's open access policy
ISSN 1471-2334
Publication date 2018-03-05
Year available 2018
Sub-type Article (original research)
DOI 10.1186/s12879-018-3011-2
Open Access Status DOI
Volume 18
Issue 1
Total pages 9
Place of publication London, United Kingdom
Publisher BioMed Central
Language eng
Subject 2725 Infectious Diseases
Abstract 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.

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.

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%.

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.
Keyword Bacteraemia
Complication
Mortality
Staphylococcus aureus
Treatment failure
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID GNT1073378
GNT1923526
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
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Created: Wed, 14 Mar 2018, 10:08:41 EST