Universität zu Köln

Joost, Insa, Kaasch, Achim ORCID: 0000-0002-6659-6738, Pausch, Christine, Peyerl-Hoffmann, Gabriele, Schneider, Christian, Voll, Reinhard E., Seifert, Harald, Kern, Winfried V. and Rieg, Siegbert ORCID: 0000-0001-7493-7080 (2017). Staphylococcus aureus bacteremia in patients with rheumatoid arthritis - Data from the prospective INSTINCT cohort. J. Infect., 74 (6). S. 575 - 585. LONDON: W B SAUNDERS CO LTD. ISSN 1532-2742

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Abstract

Objectives: Patients with rheumatoid arthritis (RA) are considered to be at increased risk of severe infections. We here describe the clinical characteristics, course and outcome of RA patients with Staphylococcus aureus bacteremia (SAB). Methods: We conducted a post hoc analysis of data from a German bi-center prospective SAB cohort study (period 2006-2014). Patients were followed-up for one year. Primary and secondary outcomes were survival time and osteoarticular infection (OAI). Results: A total of 1069 patients with SAB were analyzed, with 31 patients suffering from RA. RA patients showed significantly more often OAI (15/31 patients, 48% vs. 152/1038, 15%), disseminated infection (12/31, 39% vs. 164/1038, 16%) and severe sepsis/septic shock (12/31, 39% vs. 235/1038, 23%). Day-30 mortality in RA patients was 36% (vs. 19% in non-RA patients, p = 0.034), and day 90 mortality was 58% (vs. 32%, p = 0.003). Multivariate analyses confirmed RA to be an independent risk factor for death (HR 2.3, 95% CI 1.4-3.7) and OAI (OR 4.2, 95% CI 1.8-9.8). Conclusions: Patients with RA exhibit a complicated SAB course and a high mortality, their management is challenging. Adequate antibiotic treatment, prompt invasive diagnostic and therapeutic procedures like joint lavage or surgery are of pivotal importance. Joint damage due to RA may confer a higher risk of acquiring OAI than immunosuppression. (C) 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Joost, Insa UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaasch, Achim UNSPECIFIED orcid.org/0000-0002-6659-6738 UNSPECIFIED Pausch, Christine UNSPECIFIED UNSPECIFIED UNSPECIFIED Peyerl-Hoffmann, Gabriele UNSPECIFIED UNSPECIFIED UNSPECIFIED Schneider, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Voll, Reinhard E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Kern, Winfried V. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rieg, Siegbert UNSPECIFIED orcid.org/0000-0001-7493-7080 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-228733
DOI:	10.1016/j.jinf.2017.03.003
Journal or Publication Title:	J. Infect.
Volume:	74
Number:	6
Page Range:	S. 575 - 585
Date:	2017
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 SEPTIC ARTHRITIS; RISK-FACTORS; INFECTION; MORTALITY; OSTEOMYELITIS; EPIDEMIOLOGY; PREDICTORS; THERAPY; SEPSIS; CELL Multiple languages Infectious Diseases Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/22873