The impact of hemodialysis on mortality risk and cause of death in Staphylococcus aureus endocarditis

Chaudry, Mavish; Gislason, Gunnar; Kamper, Anne-Lise; Rix, Marianne; Dahl, Anders; Østergaard, Lauge; Fosbøl, Emil Loldrup; Lauridsen, Trine K.; Oestergaard, Louise Bruun; Hassager, Christian; Torp‐Pedersen, Christian; Bruun, Niels Eske

doi:10.1186/s12882-018-1016-0

Cited by 12 publications

(6 citation statements)

References 43 publications

(56 reference statements)

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“…Complicated SAB represented 67.6% of the cohort, with the median age of the cohort 68.5 years (IQR:29.0). Age was significantly associated with complications and this is also reflected in other studies [ 5 , 32 , 36 , 43 ].…”

Section: Discussionsupporting

confidence: 78%

C-reactive protein predicts complications in community-associated S. aureus bacteraemia: a cohort study

et al. 2021

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Background Staphylococcus aureus (S. aureus) bacteraemia is increasingly acquired from community settings and is associated with a mortality rate of up to 40% following complications. Identifying risk factors for complicated S. aureus bacteraemia would aid clinicians in targeting patients that benefit from expedited investigations and escalated care. Methods In this prospective observational cohort study, we aimed to identify risk factors associated with a complicated infection in community-onset S. aureus bacteraemia. Potential risk factors were collected from electronic medical records and included: - patient demographics, symptomology, portal of entry, and laboratory results. Results We identified several potential risk factors using univariate analysis. In a multiple logistic regression model, age, haemodialysis, and entry point from a diabetic foot ulcer were all significantly protective against complications. Conversely, an unknown entry point of infection, an entry point from an indwelling medical device, and a C-reactive protein concentration of over 161 mg/L on the day of admission were all significantly associated with complications. Conclusions We conclude that several factors are associated with complications including already conducted laboratory investigations and portal of entry of infection. These factors could aid the triage of at-risk patients for complications of S. aureus bacteraemia.

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Section: Discussionsupporting

confidence: 78%

C-reactive protein predicts complications in community-associated S. aureus bacteraemia: a cohort study

et al. 2021

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“…Previous studies conducted in oncology, hemodialysis and ICU patients with a S. aureus CLABSI all found higher mortality rates (19–24% [ 16 , 36 ], 10–19% [ 37 , 38 ] and 18–53% [ 39 ], respectively). Our data on mortality and survival probabilities are, however, difficult to compare with the previous literature, because reported time periods and used mortality definitions differ highly among studies [ 11 , 12 , 14 , 34 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ]. For example, Ghanem et al [ 36 ] reported all-cause mortality at 3 months, while Blot et al [ 39 ] reported a 30-day all-cause mortality, and Fowler et al [ 14 , 43 ] frequently report on SAB attributable mortality.…”

Section: Discussionmentioning

confidence: 95%

“…For example, Ghanem et al [ 36 ] reported all-cause mortality at 3 months, while Blot et al [ 39 ] reported a 30-day all-cause mortality, and Fowler et al [ 14 , 43 ] frequently report on SAB attributable mortality. As said, chosen time periods to determine mortality rates differ widely as well: calculation may be based on days counted between death date and either date of positive blood culture or either date of discharge or even date of treatment discontinuation [ 11 , 12 , 14 , 34 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Outcomes of S. Aureus Bacteremia in Patients Receiving Total Parenteral Nutrition

et al. 2020

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Background: Patients on total parenteral nutrition (TPN) are at risk of developing central line-associated infections. Specifically, Staphylococcus aureus bacteremia (SAB) is feared for its high complication rates. This prospective cohort study compares characteristics, clinical course and outcome of SAB in patients with and without TPN support. Methods: Clinical and microbiological data from all patients with positive blood cultures for S. aureus from two facilities, including our referral center for TPN support, were retrieved (period 2013–2020). Primary outcome was overall mortality, and included survival analysis using a multivariate Cox regression model. Secondary outcomes comprised a comparison of clinical characteristics and outcomes between both patient groups and analysis of factors associated with complicated outcome (e.g., endocarditis, deep-seated foci, relapse and death) in patients on TPN specifically. Results: A total of 620 SAB cases were analyzed, of which 53 cases received TPN at the moment the blood culture was taken. Patients in the TPN group were more frequently female, younger and had less comorbidity (p < 0.001). In-hospital death and overall mortality were significantly lower in TPN patients (4% vs. 18%, p = 0.004 and 10% vs. 34%, p < 0.001, respectively). Positive follow-up blood cultures, delayed onset of therapy and previous catheter problems were associated with a higher incidence of complicated SAB outcome in patients on TPN. Conclusion: Our data show that patients on TPN have a milder course of SAB with lower mortality rates compared to non-TPN SAB patients.

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“… 1 Patients receiving dialysis are predisposed to infections due to several factors such as old age, diabetes, accumulation of uraemic toxins, and an impaired immune system. 10 Additionally, the use of temporary or permanent catheters as vascular access and the frequent skin perforation in the use of AV fistulae are acknowledged as the most likely port of entrance for bacteraemia and sepsis. 11 Amoxicillin/clavulanic acid and clindamycin are frequently used antibiotics in patients in need of chronic HD, mainly to treat respiratory infections and wound infections.…”

Section: Discussionmentioning

confidence: 99%

Plasma concentration of orally administered amoxicillin and clindamycin in patients receiving haemodialysis

Solli

Bock

Kaur

et al. 2023

Journal of Antimicrobial Chemotherapy

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Objectives In the randomized controlled trial PANTHEM, the prophylactic effect of oral amoxicillin or clindamycin is investigated in patients receiving chronic haemodialysis (HD). However, data on plasma concentrations of these antibiotics during HD are sparse. This study aims to determine if the plasma concentration of amoxicillin and clindamycin is sufficient during HD after oral administration of amoxicillin and clindamycin at three different time intervals prior to the HD procedure. Methods Adult patients receiving chronic HD were investigated twice with an interval of at least 7 days starting with either a tablet of 500/125 mg amoxicillin/clavulanic acid or a tablet of 600 mg clindamycin. Patients were randomized to take the antibiotics either 30, 60 or 120 min prior to the HD procedure. Plasma antibiotic concentrations were measured at start, midway and at the end of HD. A lower threshold was set at 2.0 mg/L for amoxicillin and at 1.0 mg/L for clindamycin. In addition, a population pharmacokinetic (PK) analysis was performed, assessing PTA. Results In the amoxicillin cohort (n = 37), 84% of patients and 95% of all plasma amoxicillin concentrations were above or at the threshold throughout the dialysis procedure. In the clindamycin cohort (n = 33), all concentrations were above the threshold throughout the dialysis procedure. Further, in all patients, the mean plasma concentration of both amoxicillin and clindamycin across the HD period was well above the threshold. Finally, the PK model predicted a high PTA in the majority of patients. Discussion In patients on chronic HD, oral administration of amoxicillin/clavulanic acid (500/125 mg) or clindamycin (600 mg) within 30–120 min prior to HD leads to a sufficient prophylactic plasma concentration across the HD period.

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The impact of hemodialysis on mortality risk and cause of death in Staphylococcus aureus endocarditis

Cited by 12 publications

References 43 publications

C-reactive protein predicts complications in community-associated S. aureus bacteraemia: a cohort study

C-reactive protein predicts complications in community-associated S. aureus bacteraemia: a cohort study

Clinical Characteristics and Outcomes of S. Aureus Bacteremia in Patients Receiving Total Parenteral Nutrition

Plasma concentration of orally administered amoxicillin and clindamycin in patients receiving haemodialysis

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