Effect of Automated Telephone Infectious Disease Consultations to Nonacademic Hospitals on 30-Day Mortality Among Patients With <i>Staphylococcus aureus</i> Bacteremia

Weis, Sebastian; Hagel, Stefan; Palm, Julia; Scherag, André; Kolanos, Steffi; Bahrs, Christina; Löffler, Bettina; Schmitz, Roland; Rißner, Florian; Brunkhorst, Frank M.; Pletz, Mathias W.

doi:10.1001/jamanetworkopen.2022.18515

Cited by 5 publications

(2 citation statements)

References 34 publications

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“…Our hospital has a bacteraemia program, in which all patients with positive blood cultures are checked daily by physicians with training in infectious diseases. This type of program has been associated with better management of patients with bacteremia and a reduction in mortality, hospital stay, and costs [23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Improving the DENOVA score with the time to blood culture positivity in community acquired Enterococcus faecalis bacteremia

Pérez-Rodríguez,

Lima,

Garrido

et al. 2023

Preprint

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INTRODUCTION: DENOVA index has been developed to stratify the risk of infective endocarditis (IE) in patients with Enterococcus faecalis bacteremia. Recently, time to positive (TTP) of blood cultures of E. faecalis has also be related with a higher risk of IE. The objective of the study was to evaluate DENOVA scale with TTP to improve de specificity of the score. MATERIAL AND METHOD: Retrospective, case-control study in adult patients with E. faecalis bacteremia. Patients with definite enterococcal IE were classified as cases. Patients with enterococcal bacteremia and after exclusion of IE were included as control. The probability that DENOVA ± TDP correctly diagnoses patients with IE was estimated using ROC curves. RESULTS: A total of 39 patients with definite E. faecalis IE and 82 patients with E. faecalis bacteremia were included. Nosocomial-acquired bacteremia was observed in 43% of patients. The best value of AUC was obtained by the DENOVA scale without TTP, (AUC = 0.896). In the community bacteremia subgroup, the addition of a TTP ≤ 8 hours to the DENOVA scale improved the accuracy in the prediction of IE (AUC = 0.914). A shorter TTP was not related with a worse prognosis in patients with E. faecalis bacteremia. The only factor related with poor clinical outcome was a Charlson index ≥ 3 (OR 3.4, 95% CI [1.21–9.62], p = 0.020). CONCLUSIONS: In patients with E. faecalis community-acquired bacteremia, the TTP ≤ 8 hours associated with the DENOVA score could improve the prediction of this index in the detection of patients with IE.

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Section: Discussionmentioning

confidence: 99%

Improving the DENOVA score with the time to blood culture positivity in community acquired Enterococcus faecalis bacteremia

Pérez-Rodríguez,

Lima,

Garrido

et al. 2023

Preprint

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“…It is ranked second after Escherichia coli causing community-acquired and nosocomial bloodstream infections with 10 to 30 cases per 100.000 person-years (22,23). The associated fatality rate of 10-30% leads to a calculated mortality of 2-10 deaths per 100.000 individuals in the population (24,25). The Gram-positive pathogen can infect virtually any tissue or organ and readily growth on artificial surfaces of implanted foreign bodies or intravascular or urinary catheters.…”

Section: Introductionmentioning

confidence: 99%

Staphylococcus aureus induces tolerance in human monocytes accompanied with expression changes of cell surface markers

Baldauf

Hornischer

et al. 2023

Front. Immunol.

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Exposure of human monocytes to lipopolysaccharide (LPS) or other pathogen-associated molecular pattern (PAMPs) induces a temporary insensitivity to subsequent LPS challenges, a cellular state called endotoxin tolerance (ET), associated with the pathogenesis of sepsis. In this study, we aimed to characterize the cellular state of human monocytes from healthy donors stimulated with Staphylococcus aureus in comparison to TLR2-specific ligands. We analyzed S. aureus induced gene expression changes after 2 and 24 hours by amplicon sequencing (RNA-AmpliSeq) and compared the pro-inflammatory response after 2 hours with the response in re-stimulation experiments. In parallel, glycoprotein expression changes in human monocytes after 24 hours of S. aureus stimulation were analyzed by proteomics and compared to stimulation experiments with TLR2 ligands Malp-2 and Pam3Cys and TLR4 ligand LPS. Finally, we analyzed peripheral blood monocytes of patients with S. aureus bloodstream infection for their ex vivo inflammatory responses towards S. aureus stimulation and their glycoprotein expression profiles. Our results demonstrate that monocytes from healthy donors stimulated with S. aureus and TLR ligands of Gram-positive bacteria entered the tolerant cell state after activation similar to LPS treatment. In particular reduced gene expression of pro-inflammatory cytokines (TNF, IL1β) and chemokines (CCL20, CCL3, CCL4, CXCL2, CXCL3 and CXCL8) could be demonstrated. Glycoprotein expression changes in monocytes tolerized by the different TLR agonists were highly similar while S. aureus-stimulated monocytes shared some of the PAMP-induced changes but also exhibited a distinct expression profile. 11 glycoproteins (CD44, CD274, DSC2, ICAM1, LAMP3, LILRB1, PTGS2, SLC1A3, CR1, FGL2, and HP) were similarly up- or downregulated in all four comparisons in the tolerant cell state. Monocytes from patients with S. aureus bacteremia revealed preserved pro-inflammatory responsiveness to S. aureus stimulation ex vivo, expressed increased CD44 mRNA but no other glycoprotein of the tolerance signature was differentially expressed.

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Behandlung von Staphylococcus-aureus-Blutstrominfektionen

et al. 2022

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Effect of Automated Telephone Infectious Disease Consultations to Nonacademic Hospitals on 30-Day Mortality Among Patients With Staphylococcus aureus Bacteremia

Cited by 5 publications

References 34 publications

Improving the DENOVA score with the time to blood culture positivity in community acquired Enterococcus faecalis bacteremia

Improving the DENOVA score with the time to blood culture positivity in community acquired Enterococcus faecalis bacteremia

Staphylococcus aureus induces tolerance in human monocytes accompanied with expression changes of cell surface markers

Behandlung von Staphylococcus-aureus-Blutstrominfektionen

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