Universität zu Köln

Kaasch, Achim J., Barlow, Gavin, Edgeworth, Jonathan D., Fowler, Vance G., Hellmich, Martin, Hopkins, Susan ORCID: 0000-0001-5179-5702, Kern, Winfried V., Llewelyn, Martin J., Rieg, Siegbert ORCID: 0000-0001-7493-7080, Rodriguez-Bano, Jesus ORCID: 0000-0001-6732-9001, Scarborough, Matthew ORCID: 0000-0002-0455-0785, Seifert, Harald, Soriano, Alex ORCID: 0000-0002-9374-0811, Tilley, Robert, Torok, M. Estee, Weiss, Verena, Wilson, A. Peter R. and Thwaites, Guy E. (2014). Staphylococcus aureus bloodstream infection: A pooled analysis of five prospective, observational studies. J. Infect., 68 (3). S. 242 - 252. LONDON: W B SAUNDERS CO LTD. ISSN 1532-2742

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Abstract

Objectives: Staphylococcus aureus bacteraemia is a common, often fatal infection. Our aim was to describe how its clinical presentation varies between populations and to identify common determinants of outcome. Methods: We conducted a pooled analysis on 3395 consecutive adult patients with S. aureus bacteraemia. Patients were enrolled between 2006 and 2011 in five prospective studies in 20 tertiary care centres in Germany, Spain, United Kingdom, and United States. Results: The median age of participants was 64 years (interquartile range 50-75 years) and 63.8% were male. 25.4% of infections were associated with diabetes mellitus, 40.7% were nosocomial, 20.6% were caused by methicillin-resistant S. aureus (MRSA), although these proportions varied significantly across studies. Intravenous catheters were the commonest identified infective focus (27.7%); 8.3% had endocarditis. Crude 14 and 90-day mortality was 14.6% and 29.2%, respectively. Age, MRSA bacteraemia, nosocomial acquisition, endocarditis, and pneumonia were independently associated with death, but a strong association was with an unidentified infective focus (adjusted hazard ratio for 90-day mortality 2.92; 95% confidence interval 2.33 to 3.67, p < 0.0001). Conclusion: The baseline demographic and clinical features of S. aureus bacteraemia vary significantly between populations. Mortality could be reduced by assiduous MRSA control and early identification of the infective focus. (C) 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kaasch, Achim J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Barlow, Gavin UNSPECIFIED UNSPECIFIED UNSPECIFIED Edgeworth, Jonathan D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fowler, Vance G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Hopkins, Susan UNSPECIFIED orcid.org/0000-0001-5179-5702 UNSPECIFIED Kern, Winfried V. UNSPECIFIED UNSPECIFIED UNSPECIFIED Llewelyn, Martin J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rieg, Siegbert UNSPECIFIED orcid.org/0000-0001-7493-7080 UNSPECIFIED Rodriguez-Bano, Jesus UNSPECIFIED orcid.org/0000-0001-6732-9001 UNSPECIFIED Scarborough, Matthew UNSPECIFIED orcid.org/0000-0002-0455-0785 UNSPECIFIED Seifert, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Soriano, Alex UNSPECIFIED orcid.org/0000-0002-9374-0811 UNSPECIFIED Tilley, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Torok, M. Estee UNSPECIFIED UNSPECIFIED UNSPECIFIED Weiss, Verena UNSPECIFIED UNSPECIFIED UNSPECIFIED Wilson, A. Peter R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Thwaites, Guy E. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-445405
DOI:	10.1016/j.jinf.2013.10.015
Journal or Publication Title:	J. Infect.
Volume:	68
Number:	3
Page Range:	S. 242 - 252
Date:	2014
Publisher:	W B SAUNDERS CO LTD
Place of Publication:	LONDON
ISSN:	1532-2742
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language METHICILLIN-RESISTANT; BACTEREMIA; MORTALITY; PREDICTORS; MANAGEMENT; CRITERIA Multiple languages Infectious Diseases Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/44540