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Risk Factors for Mortality in Staphylococcus aureus Bacteremia

Published online by Cambridge University Press:  02 January 2015

Lucieni Oliveira Conterno ,
Sergio Barsanti Wey  and
Adauto Castelo
Lucieni Oliveira Conterno
Affiliation:
Infectious Diseases Division of Marilia Medical School, São Paulo, Brazil
Sergio Barsanti Wey*
Affiliation:
Division of Infectious Diseases of São Paulo Federal Medical School–UNIFESP, São Paulo, Brazil
Adauto Castelo
Affiliation:
Division of Infectious Diseases of São Paulo Federal Medical School–UNIFESP, São Paulo, Brazil
*
Rua Botucatu 740, DIPA-UNIFESP, 04023-062 São Paulo, SP, Brazil
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Abstract

Objective:

To analyze risk factors for, and the role of methicillin resistance in, mortality in Staphylococcus aureus bacteremia.

Design:

Nested case-control study.

Setting:

General teaching hospital with a high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) strains, in São Paulo, Brazil.

Patients:

136 patients over 14 years old with documented S aureus bacteremia. Those who died were compared with those who survived at least 14 days.

Results:

Mortality within 14 days of bacteremia was 39% (53/136). Mean age was 47 years. Hospital-acquired bacteremia represented 86% (117/136) of episodes. In 26% (35/136), infection was related to an intravascular catheter and in 13% (17/136) to the respiratory tract. Septic shock occurred in 22% (30/136) of cases. MRSA was isolated in 66% (90/136). Multivariate analysis identified three variables that were significantly and independently associated with mortality: site of entry (lung, odds ratio [OR], 17.0; unknown, OR, 12.3; others, OR, 6.6); occurrence of shock (OR, 8.9), and resistance of S aureus to methicillin (OR, 4.2).

Conclusion:

Our study shows that S aureus bacteremia has a high mortality, especially when the lung is the source of infection and when shock develops; resistance to methicillin may be another risk factor for poor outcome.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 19 , Issue 1 , January 1998 , pp. 32 - 37
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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