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.
| Original language | English |
|---|---|
| Article number | 107 |
| Journal | BMC Infectious Diseases |
| Volume | 18 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 5 Mar 2018 |
Keywords
- Bacteraemia
- Complication
- Mortality
- Staphylococcus aureus
- Treatment failure
Cite this
}
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.; Owen Robinson, J.; VANESSA study group, on behalf of the Australasian Society for Infectious Diseases (ASID) Clinical Research Network (CRN).
In: BMC Infectious Diseases, Vol. 18, No. 1, 107, 05.03.2018.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Morbidity from in-hospital complications is greater than treatment failure in patients with Staphylococcus aureus bacteraemia
AU - Holmes, Natasha E.
AU - Robinson, J. Owen
AU - van Hal, Sebastiaan J.
AU - Munckhof, Wendy J.
AU - Athan, Eugene
AU - Korman, Tony M.
AU - Cheng, Allen C.
AU - Turnidge, John D.
AU - Johnson, Paul D.R.
AU - Howden, Benjamin P.
AU - Owen Robinson, J.
AU - VANESSA study group, on behalf of the Australasian Society for Infectious Diseases (ASID) Clinical Research Network (CRN)
PY - 2018/3/5
Y1 - 2018/3/5
N2 - 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.
AB - 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.
KW - Bacteraemia
KW - Complication
KW - Mortality
KW - Staphylococcus aureus
KW - Treatment failure
UR - http://www.scopus.com/inward/record.url?scp=85043315480&partnerID=8YFLogxK
U2 - 10.1186/s12879-018-3011-2
DO - 10.1186/s12879-018-3011-2
M3 - Article
VL - 18
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
SN - 1471-2334
IS - 1
M1 - 107
ER -