Universität zu Köln

Camp, Johannes ORCID: 0000-0003-3914-4477, Glaubitz, Lina, Filla, Tim, Kaasch, Achim J., Fuchs, Frieder ORCID: 0000-0001-7075-5378, Scarborough, Matt, Kim, Hong Bin ORCID: 0000-0001-6262-372X, Tilley, Robert, Liao, Chun-Hsing ORCID: 0000-0002-4099-3487, Edgeworth, Jonathan, Nsutebu, Emmanuel, Lopez-Cortes, Luis Eduardo, Morata, Laura, Llewelyn, Martin ORCID: 0000-0002-6811-1124, Fowler, Vance G., Thwaites, Guy, Seifert, Harald, Kern, Winfried, V, Kuss, Oliver and Rieg, Siegbert (2021). Impact of Immunosuppressive Agents on Clinical Manifestations and Outcome of Staphylococcus aureus Bloodstream Infection: A Propensity Score-Matched Analysis in 2 Large, Prospectively Evaluated Cohorts. Clin. Infect. Dis., 73 (7). S. 1239 - 1248. CARY: OXFORD UNIV PRESS INC. ISSN 1537-6591

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Abstract

Background. Staphylococcus aureus bloodstream infection (SAB) is a common, life-threatening infection. The impact of immunosuppressive agents on the outcome of patients with SAB is incompletely understood. Methods. Data from 2 large prospective, international, multicenter cohort studies (Invasive Staphylococcus aureus Infections Cohort [INSTINCT] and International Staphylococcus aureus Collaboration [ISAC]) between 2006 and 2015 were analyzed. Patients receiving immunosuppressive agents were identified and a 1:1 propensity score-matched analysis was performed to adjust for baseline characteristics of patients. Overall survival and time to SAB-related late complications (SAB relapse, infective endocarditis, osteomyelitis, or other deep-seated manifestations) were analyzed by Cox regression and competing risk analyses, respectively. This approach was then repeated for specific immunosuppressive agents (corticosteroid monotherapy and immunosuppressive agents other than steroids [IMOTS]). Results. Of 3188 analyzed patients, 309 were receiving immunosuppressive treatment according to our definitions and were matched to 309 nonimmunosuppressed patients. After propensity score matching, baseline characteristics were well balanced. In the Cox regression analysis, we observed no significant difference in survival between the 2 groups (death during follow-up: 105/309 [33.9%] immunosuppressed vs 94/309 [30.4%] nonimmunosuppressed; hazard ratio [HR], 1.20 [95% confidence interval {CI}, .84-1.71]). Competing risk analysis showed a cause-specific HR of 1.81 (95% CI,.85-3.87) for SAB-related late complications in patients receiving immunosuppressive agents. The cause-specific HR was higher in patients taking IMOTS (3.69 [95% CI, 1.41-9.68]). Conclusions. Immunosuppressive agents were not associated with an overall higher mortality. The risk for SAB-related late complications in patients receiving specific immunosuppressive agents such as IMOTS warrants further investigations.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Camp, Johannes UNSPECIFIED orcid.org/0000-0003-3914-4477 UNSPECIFIED Glaubitz, Lina UNSPECIFIED UNSPECIFIED UNSPECIFIED Filla, Tim UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaasch, Achim J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, Frieder UNSPECIFIED orcid.org/0000-0001-7075-5378 UNSPECIFIED Scarborough, Matt UNSPECIFIED UNSPECIFIED UNSPECIFIED Kim, Hong Bin UNSPECIFIED orcid.org/0000-0001-6262-372X UNSPECIFIED Tilley, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Liao, Chun-Hsing UNSPECIFIED orcid.org/0000-0002-4099-3487 UNSPECIFIED Edgeworth, Jonathan UNSPECIFIED UNSPECIFIED UNSPECIFIED Nsutebu, Emmanuel UNSPECIFIED UNSPECIFIED UNSPECIFIED Lopez-Cortes, Luis Eduardo UNSPECIFIED UNSPECIFIED UNSPECIFIED Morata, Laura UNSPECIFIED UNSPECIFIED UNSPECIFIED Llewelyn, Martin UNSPECIFIED orcid.org/0000-0002-6811-1124 UNSPECIFIED Fowler, Vance G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Thwaites, Guy UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Kern, Winfried, V UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuss, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Rieg, Siegbert UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-605181
DOI:	10.1093/cid/ciab385
Journal or Publication Title:	Clin. Infect. Dis.
Volume:	73
Number:	7
Page Range:	S. 1239 - 1248
Date:	2021
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1537-6591
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MEDICAL PROGRESS; BACTEREMIA; EPIDEMIOLOGY; PERSISTENCE; MANAGEMENT; MORTALITY; SURVIVAL; THERAPY; BALANCE Multiple languages Immunology; Infectious Diseases; Microbiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60518