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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 DR, Howden, Benjamin P and VANESSA study group, on behalf of the Australasian Society for Infectious Diseases (ASID) Clinical Research Network (CRN) 2018, Morbidity from in-hospital complications is greater than treatment failure in patients with Staphylococcus aureus bacteraemia, BMC infectious diseases, vol. 18, pp. 1-9, doi: 10.1186/s12879-018-3011-2.

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Title Morbidity from in-hospital complications is greater than treatment failure in patients with Staphylococcus aureus bacteraemia
Formatted title Morbidity from in-hospital complications is greater than treatment failure in patients with Staphylococcus aureus bacteraemia
Author(s) Holmes, Natasha E
Robinson, J Owen
van Hal, Sebastiaan J
Munckhof, Wendy J
Athan, EugeneORCID iD for Athan, Eugene orcid.org/0000-0001-9838-6471
Korman, Tony M
Cheng, Allen C
Turnidge, John D
Johnson, Paul DR
Howden, Benjamin P
VANESSA study group, on behalf of the Australasian Society for Infectious Diseases (ASID) Clinical Research Network (CRN)
Journal name BMC infectious diseases
Volume number 18
Article ID 107
Start page 1
End page 9
Total pages 9
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2018-03-05
ISSN 1471-2334
Keyword(s) Staphylococcus aureus
bacteraemia
treatment failure
complication
mortality
adult
age factors
aged
aged, 80 and over
anti-bacterial agents
Australia
C-reactive protein
cohort studies
echocardiography
female
hospital mortality
hospitalization
humans
logistic models
male
microbial sensitivity tests
middle aged
morbidity
risk factors
Staphylococcal infections
vancomycin
science & technology
life sciences & biomedicine
infectious diseases
Summary 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.
Language eng
DOI 10.1186/s12879-018-3011-2
Field of Research 0605 Microbiology
1103 Clinical Sciences
1108 Medical Microbiology
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2018, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30110105

Document type: Journal Article
Collections: School of Medicine
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.