Staphylococcus aureus bacteraemia with known sources

Rubinstein, Ethan

doi:10.1016/j.ijantimicag.2008.06.006

Cited by 36 publications

(28 citation statements)

References 18 publications

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“…A growing proportion of these bloodstream infections are due to methicillin-resistant Staphylococcus aureus (MRSA), which is associated with worse clinical outcome, longer hospitalization, and higher net cost than similar infections caused by methicillin-susceptible S. aureus (MSSA) (3,6,14,15,26,49,52,60). Persistent-bacteremia (PB) outcomes comprise 20 to 30% of all episodes of MRSA bacteremia and are especially relevant to endovascular infections (13,22,23,31).…”

mentioning

confidence: 99%

Combinatorial Phenotypic Signatures Distinguish Persistent from Resolving Methicillin-Resistant Staphylococcus aureus Bacteremia Isolates

Seidl

Bayer

Fowler

et al. 2011

Antimicrob Agents Chemother

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Persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia (PB) (positive blood cultures after >7 days of therapy) represents a clinically challenging subset of invasive MRSA infections. In this investigation, we examined the potential correlation of specific virulence signatures with PB versus resolving MRSA bacteremia (RB) (negative blood cultures within 2 to 4 days of therapy) strains. Thirty-six MRSA isolates from patients enrolled in a recent multinational clinical trial were studied for (i) susceptibility to host defense cationic peptides (HDPs) (i.e., thrombin-induced platelet microbicidal proteins [tPMPs] and human neutrophil peptide 1 [hNP-1]); (ii) adherence to host endovascular ligands (fibronectin) and cells (endothelial cells); and (iii) biofilm formation. We found that PB isolates exhibited significantly reduced susceptibilities to tPMPs and hNP-1 (P < 0.001 and P ‫؍‬ 0.023, respectively). There was no significant association between the PB outcome and fibronectin binding, endothelial cell binding, or biofilm formation (P ‫؍‬ 0.25, 0.97, and 0.064 versus RB strains, respectively). However, multiple logistic regression analysis revealed that the PB outcome was significantly associated with the combination of reduced susceptibilities to HDPs and extent of biofilm formation (P < 0.0001). Similar results were obtained in a second analysis using days of bacteremia as a continuous outcome, showing that reduced HDP susceptibilities and increased biofilm formation cocontributed to predict the duration of bacteremia. Our data indicate that PB isolates have specific pathogenic signatures independent of conventional antimicrobial susceptibility. These combinatorial mosaics can be defined and used to prospectively distinguish PB from RB strains in advance and potentially to predict ultimate clinical outcomes.Staphylococcus aureus is a leading cause of bacteremia and infective endocarditis (IE) throughout the industrialized world (18,22,42,54). A growing proportion of these bloodstream infections are due to methicillin-resistant Staphylococcus aureus (MRSA), which is associated with worse clinical outcome, longer hospitalization, and higher net cost than similar infections caused by methicillin-susceptible S. aureus (MSSA) (3,6,14,15,26,49,52,60). Persistent-bacteremia (PB) outcomes comprise 20 to 30% of all episodes of MRSA bacteremia and are especially relevant to endovascular infections (13,22,23,31). Why some MRSA bacteremia strains persist while others resolve (RB) despite similar baseline clinical and microbiologic characteristics and identical medical and surgical therapeutic strategies is poorly understood.In two recent studies, we investigated S. aureus virulence factors that could potentially differentiate PB from RB strains in the context of endovascular infections (23, 56). We initially studied PB or RB isolates from the Duke University Medical Center and delineated several in vitro parameters that appeared to distinguish these two strain cohorts, including enhanced matrix ligand and e...

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confidence: 99%

Combinatorial Phenotypic Signatures Distinguish Persistent from Resolving Methicillin-Resistant Staphylococcus aureus Bacteremia Isolates

Seidl

Bayer

Fowler

et al. 2011

Antimicrob Agents Chemother

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“…The increase in MRSA was supported by previous results. S. aureus accounted for 20-40% of all hospital-acquired and ventilatorassociated pneumonia, with MRSA being the predominant microorganism (12). A survey of 59 US hospitals involving 4,543 patients with culture-positive pneumonia between January 2002 and January 2004 identified MRSA as a potential pathogen in community-acquired pneumonia (8.9%), healthcare-associated pneumonia (26.5%), and hospitalacquired (22.9%) and ventilator-associated (14.6%) pneumonia (13).…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Bacterial Species in Positive Blood Cultures among Hospitalized Patients in Three Wards in the Department of Internal Medicine: Retrospective Chart Review 1999-2008

et al. 2012

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Objective This study aimed to establish the clinical significance of positive blood cultures during the past 10 years in Saga University Hospital. Methods All hospitalized patients with positive blood cultures in the gastroenterology, hepatology and respiratory wards in the Department of Internal Medicine, Saga University Hospital were evaluated by retrospective chart review between January 1999 and December 2008. The results were compared between period I (1999)(2000)(2001)(2002)(2003) and period II (2004II ( -2008. Results During the study, 2,680 isolates from 22,694 samples (11.8%) were detected in Saga University Hospital: 106 (13.1%) isolates from 812 samples were detected in the gastroenterology ward; 71 (7.8%) from 914 in the hepatology ward; and 160 (6.0%) from 2,671 in the respiratory ward. The number of positive blood cultures increased during period II compared with period I in all three wards. The ratio of Gramnegative rods increased in the gastroenterology ward during period II (p<0.05). The ratio of Gram-positive cocci was higher in the respiratory ward compared with the other two wards (p<0.05 in each). In contrast, the ratio of Gram-negative rods was higher in the gastroenterology and hepatology wards (p<0.05 in each). Fungemia increased in the gastroenterology and respiratory wards in period II (p<0.05 in each). Conclusion The trends in bacterial species in positive blood cultures differed between the gastroenterology, hepatology and respiratory wards. This could be important for decision making regarding antimicrobial therapy in the early therapeutic phase.

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“…Staphylococcus aureus is responsible for two thirds of cases, with the incidence of MRSA increasing in recent years [24]. Epidural abscess is one of the most dire consequences of metastatic bacteremia, frequently resulting in paralysis [25], and usually develops as a complication of craniotomy or compound skull fracture or in patients with implantable spinal or vascular devices. Thus, it rarely occurs in healthy people living in community settings.…”

Section: Discussionmentioning

confidence: 99%

Epidural abscess caused by community-associated methicillin-resistant Staphylococcus aureus strain USA300 in Japan

Higashiyama

Ito

Han

et al. 2010

Journal of Infection and Chemotherapy

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Staphylococcus aureus bacteraemia with known sources

Cited by 36 publications

References 18 publications

Combinatorial Phenotypic Signatures Distinguish Persistent from Resolving Methicillin-Resistant Staphylococcus aureus Bacteremia Isolates

Combinatorial Phenotypic Signatures Distinguish Persistent from Resolving Methicillin-Resistant Staphylococcus aureus Bacteremia Isolates

Characteristics of Bacterial Species in Positive Blood Cultures among Hospitalized Patients in Three Wards in the Department of Internal Medicine: Retrospective Chart Review 1999-2008

Epidural abscess caused by community-associated methicillin-resistant Staphylococcus aureus strain USA300 in Japan

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