Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/17914
Title: Morbidity from in-hospital complications is greater than treatment failure in patients with Staphylococcus aureus bacteraemia.
Authors: 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
Affiliation: Department of Infectious Diseases, Austin Health, Austin Centre for Infection Research, Heidelberg, Victoria, Australia
Department of Microbiology and Immunology, University of Melbourne, Melbourne, VIC, Australia
Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine-WA, Royal Perth Hospital, Perth, WA, Australia
Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, School of Biomedical Sciences, Curtin University, Perth, WA, Australia
Department of Microbiology and Infectious Diseases, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
Department of Medicine, University of Western Sydney, Sydney, NSW, Australia
Infection Management Services, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
Department of Medicine, University of Queensland, St Lucia, QLD, Australia
Department of Infectious Diseases, University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
Department of Medicine, Deakin University, Geelong, VIC, Australia
Department of Medicine, University of Melbourne, Parkville, VIC, Australia
Department of Infectious Diseases, Monash Health, Clayton, VIC, Australia
Department of Medicine, Monash University, Clayton, VIC, Australia
Department of Infectious Diseases, Alfred Hospital, Prahran, VIC, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Prahran, VIC, Australia
Australian Commission on Safety and Quality in Health Care, Sydney, NSW, Australia
Department of Paediatrics, University of Adelaide, Adelaide, SA, Australia
Department of Microbiology, Monash University, Clayton, VIC, Australia
Microbiological Diagnostic Unit, Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
Issue Date: 5-Mar-2018
EDate: 2018-03-05
Citation: BMC infectious diseases 2018; 18(1): 107
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.
URI: http://ahro.austin.org.au/austinjspui/handle/1/17914
DOI: 10.1186/s12879-018-3011-2
PubMed URL: 29506483
Type: Journal Article
Research Support, Non-U.S. Gov't
Subjects: Bacteraemia
Complication
Mortality
Staphylococcus aureus
Treatment failure
Appears in Collections:Journal articles

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