Hospital and community-acquired Staphylococus aureus bacteraemia: risk factors, location of inflammation and outcome
Abstract number: 902_p1349
To access the incidence, to recognise risk factors and describe location of specific tissue inflammation along with the outcome of patients with community acquired and nosocomial Staphylococcus aureus bacteraemia (SAB), treated in a tertiary medical department.
This is retrospective study of 7250 patients who were hospitalised in a medical department, during 7-year period (January 1995 to January 2002). Community acquired and nosocomial SAB were determined according to positive blood cultures, taken less or >72 h from admission, respectively. Categorical variables were compared with Chi-square techniques.
During the 7-year period, 55 (28 male, 33 female) and 182 (85 male, 97 female) patients developed community acquired and nosocomial SAB corresponding to an incidence of 1 per 1000 person years and 3.5 per 1000 person years, respectively. Risk factors for the developed of SAB bacteraemia in group A vs. group B, was: injection drug use: 12 (21.8%) vs. 17 (9.3%) (P = 0.02), haemodialysis-dependent patients: seven (12.7%) vs. 18 (9.9%) (P = NS), diabetes mellitus: 20 (36.4%) vs. 16 (8.8%) (P = 0.01), neoplasmatic diseases: five (9.1%) vs 18 (9.9%) (P = NS), corticosteroid use: eight (14.5%) vs. 62 (34.1%) (P = 0.01), haematologic disorders: three (5.5%) vs. 28 (15.4%) (P = 0.05), surgery within the previous 30 days: 0 vs. 10 (5.5%) (P = NS)
Determination of location of septic inflammation was feasible in 29 (52.7%, group A) vs. 94 (51.6%, group B) (P = NS), including: deep tissue abscess: five (9.1%) vs. 23 (12.6%) (P = NS), psoas abscess: two (3.6%) vs. 18 (9.9%) (P = NS), vertebral osteomyelitis: four (7.3%) vs. 12 (6.6%) (P = NS), soft-tissue infection: 10 (18.2%) vs. eight (4.4%) (P = 0.01), septic arthritis: two (3.6%) vs. nine (4.9%) (P = NS), septic thrombophlebitis: four (7.3%) vs. eight (4.4%) (P = NS), endocarditis: two (3.6%) vs. eight (4.4%) (P = NS), meningitis: zero vs. eight (4.4%) (P = NS), infection of orthopaedic prosthetic devises: zero vs. 13 (7.1%) (P = NS). Mortality was three (5.5%, group A) and 28 (15.4%, group B), respectively (P = 0.05).
Among risk factors for community acquired SAB are injection drug use and diabetes mellitus, while for nosocomial SAB is use of corticosteroids and haematologic disorders. Soft-tissue infection was more frequent on group of community-acquired SAB. Higher mortality rate was noticed in the group of nosocomial SAB."
|Session name:||XXIst ISTH Congress|
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