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Predictive Factors for Metastatic Infection in Patients With Bacteremia Caused by Methicillin-Sensitive Staphylococcus aureus
- Source :
- The American Journal of the Medical Sciences
- Publisher :
- Southern Society for Clinical Investigation. Published by Elsevier Inc.
-
Abstract
- Background Metastatic infections such as infective endocarditis and psoas abscess are serious complications of Staphylococcus aureus bacteremia because failure to identify these infections may result in bacteremia relapse or poor prognosis. in the present study, we determined the predictive factors for metastatic infection due to methicillin-sensitive S. aureus bacteremia. Methods A retrospective cohort study was conducted among patients with methicillin-sensitive S. aureus bacteremia at the Jikei University Hospital between January 2008 and December 2012. Factors analyzed included the underlying disease, initial antimicrobial treatment and primary site of infection. Results During the 5-year study period, 73 patients met the inclusion criteria and were assessed. The most common primary site of bacteremia was catheter-related bloodstream infection (25/73 [34.2%]). Metastatic infection occurred in 14 of 73 patients (19.2%) (infective endocarditis [3], septic pulmonary abscess [3], spondylitis [4], psoas abscess [4], epidural abscess [3] and septic arthritis [1]). six patients had multiple metastatic infections. Multivariate analysis revealed that the predictive factors associated with the development of metastatic infection were a delay in appropriate antimicrobial treatment of > 48 hours, persistent fever for > 72 hours after starting antibiotic treatment and lowest C-reactive protein levels of > 3 mg/dL during 2 weeks after the onset of bacteremia. Conclusions This study demonstrated that additional diagnostic tests should be conducted to identify metastatic infection, particularly in patients with delayed antimicrobial treatment, persistent fever and persistently high C-reactive protein levels.
- Subjects :
- Male
medicine.medical_specialty
Staphylococcus aureus
Fever
Epidural abscess
medicine.drug_class
Antibiotics
Bacteremia
Staphylococcal infections
medicine.disease_cause
Methicillin
Japan
Internal medicine
Humans
Medicine
Clinical Investigation
Abscess
Aged
Retrospective Studies
Medicine(all)
business.industry
General Medicine
Staphylococcal Infections
medicine.disease
bacterial infections and mycoses
Metastatic infection
Anti-Bacterial Agents
Surgery
C-Reactive Protein
Catheter-Related Infections
Infective endocarditis
Female
Septic arthritis
business
Predictive factors
Subjects
Details
- Language :
- English
- ISSN :
- 00029629
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- The American Journal of the Medical Sciences
- Accession number :
- edsair.doi.dedup.....b2c52cf7bed43956fa8a48ccbcb23575
- Full Text :
- https://doi.org/10.1097/MAJ.0000000000000350