Predictors of Mortality in Staphylococcus aureus Bacteremia

Abstract

SUMMARY Staphylococcus aureus bacteremia (SAB) is an important infection with an incidence rate ranging from 20 to 50 cases/100,000 population per year. Between 10% and 30% of these patients will die from SAB. Comparatively, this accounts for a greater number of deaths than for AIDS, tuberculosis, and viral hepatitis combined. Multiple factors influence outcomes for SAB patients. The most consistent predictor of mortality is age, with older patients being twice as likely to die. Except for the presence of comorbidities, the impacts of other host factors, including gender, ethnicity, socioeconomic status, and immune status, are unclear. Pathogen-host interactions, especially the presence of shock and the source of SAB, are strong predictors of outcomes. Although antibiotic resistance may be associated with increased mortality, questions remain as to whether this reflects pathogen-specific factors or poorer responses to antibiotic therapy, namely, vancomycin. Optimal management relies on starting appropriate antibiotics in a timely fashion, resulting in improved outcomes for certain patient subgroups. The roles of surgery and infectious disease consultations require further study. Although the rate of mortality from SAB is declining, it remains high. Future international collaborative studies are required to tease out the relative contributions of various factors to mortality, which would enable the optimization of SAB management and patient outcomes.

Epidemiology of antimicrobial resistance in bloodstream infections

“…28 It has been estimated that in the Western countries, the incidence of CA-BSIs due to SA is approximately 15 per 100.000 and a mortality rate of 3 per 100.000. 29 Community-acquired MRSA infections have emerged as a global problem since the turn of the 21 st century. [30][31][32] Five major clones are found to be associated with most of the CA-MRSA infections worldwide including multilocus sequence type 1 (ST-1)/USA400 and ST-8/USA300 dominantly found in North America, ST-59 observed in South East Asia, ST-80 observed in Europe and ST-30 distributed worldwide 28 .…”

Clonal differences in Staphylococcus aureus bacteraemia-associated mortality

“…These model systems 16 come with their own set of limitations, and many observations contrast with those from 17 human studies. For example, whereas cytolytic toxins have previously been shown to enhance 18 disease severity in animal models of SAB 7,8 , isolates from invasive diseases in humans, such 19 as bacteraemia and pneumonia, were recently found to be significantly less toxic than those 20 isolated from skin and soft tissue infections or even those of healthy volunteers [9][10][11][12] . This raises 21 the question as to whether animal models are adequate to study bacterial virulence in human 22 SAB infections, or whether there is an important distinction between the role of toxicity in 23 the development of bacteraemia and its pathogenic effect once bacteraemia has been 24 easyCyte flow cytometry.…”

Potentiated Electron Transference in α-Ag2WO4 Microcrystals with Ag Nanofilaments as Microbial Agent

“…11 Multiple factors influence outcomes for MRSA bacteremia patients, and the most consistent predictor of mortality is age with older patients being twice as likely to die. 12 There are now limited therapeutic options for treating serious bacterial infections, and in the face of increasing resistance, there is an urgent need for new antibiotics. In particular, vancomycin hydrochloride has been the accepted standard of therapy for MRSA infections.…”