Clinical significance of Staphylococcus aureus bacteremia in patients with liver cirrhosis

Park, H. J.; Lee, Y.-M.; Bang, Kyung-Mi; Park, S.-Y.; Moon, Song Mi; Park, K.-H.; Chong, Yong Pil; Kim, S.-H.; Lee, S.-O.; Choi, Sang‐Ho; Jeong, Jin‐Yong; Woo, Jun Hee; Kim, Y. S.

doi:10.1007/s10096-012-1697-4

Cited by 17 publications

(11 citation statements)

References 21 publications

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“…Indices of the severity of comorbidities and illness are known to be associated with death of patients with S. aureus bacteremia (SAB) [11-13,30,31], and most previous studies investigated the factors associated with late mortality, such as 30-day mortality [11-13,30,31]. The exception is a recent study by Gasch et al [6], which looked at early mortality, defined as death within 2 days of the onset of MRSAB, as in the current study.…”

Section: Discussionmentioning

confidence: 99%

Clinical and microbiological factors associated with early patient mortality from methicillin-resistant Staphylococcus aureus bacteremia

Kim

Chong

Park

et al. 2019

Korean J Intern Med

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Section: Discussionmentioning

confidence: 99%

Clinical and microbiological factors associated with early patient mortality from methicillin-resistant Staphylococcus aureus bacteremia

Kim

Chong

Park

et al. 2019

Korean J Intern Med

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“…In addition, ST131-producing CTX-M-15 has been found prevalent in Japan, with rare cases described in Indonesia and China. [10-13] Until this report, a detailed report of virulence data related to ST131 in Taiwan was lacking. In our previous study, we found ST131 in about one third of patients with bacteremia and ESBL-EC.…”

Section: Introductionmentioning

confidence: 99%

Bloodstream Infection with Extended-spectrum Beta-lactamase–producingEscherichia coli: the role of virulence genes

Hung

Cheng

Tseng

et al. 2018

Preprint

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27 Background: Various bacterial putative virulence factors are involved in the 28 pathogenesis of bacterial infection. However, the effect of comorbidities or infection 29 syndrome in the association of virulence factors and mortality remains inconclusive. 30 Method: This study addressed whether specific sequence type (ST) and virulence 31 factors of extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-EC) 32 are associated with different outcomes in patients with bloodstream infection.121 33 adults from southern Taiwan with ESBL-producing E. coli bloodstream infections 34 were enrolled during a 6-year period. Demographic data, including infection 35 syndromes, underlying disease and outcomes, were collected. The virulence factors in 36 isolates were analyzed by PCR and multilocus sequence typing. 37 Result: Positivity for the virulence genes iha, hlyD, sat, iut, fyu, malX, ompT, usp and 38 traT was associated with ST131 positivity (P<0.05). Some ESBL-EC virulence genes 39 associated with urinary tract infection (UTI) were revealed. Positivity for ST405 and 40 the virulence genes iroN and iss was significantly associated with increased 30-day 41 mortality (death within 30 days) on univariate analysis (P<0.05). Independent risk 42 factors of 30-day mortality in bacteremic patients with UTI included underlying 43 chronic liver disease and malignancy. ST131 was borderline associated with 30-day 44 mortality. Independent risk factors associated with 30-day mortality among 45 bacteremic patients without UTI included comorbidities and iroN positivity. 46

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“…A more recent study examined S. aureus bacteraemia in patients with and without cirrhosis. 16 Patients with cirrhosis had a higher 30 day mortality than those without cirrhosis: septic shock and advanced liver disease (Child–Pugh class 3) were associated with increased mortality. Finally, Gustot et al .…”

Section: Discussionmentioning

confidence: 98%

“…These findings add to the limited information available on MRSA carriage and infection in patients with cirrhosis. 11–16 …”

Section: Introductionmentioning

confidence: 99%

Zero tolerance for healthcare-associated MRSA bacteraemia: is it realistic?

Török¹,

Harris²,

Cartwright³

et al. 2014

Journal of Antimicrobial Chemotherapy

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BackgroundThe term ‘zero tolerance’ has recently been applied to healthcare-associated infections, implying that such events are always preventable. This may not be the case for healthcare-associated infections such as methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia.MethodsWe combined information from an epidemiological investigation and bacterial whole-genome sequencing to evaluate a cluster of five MRSA bacteraemia episodes in four patients in a specialist hepatology unit.ResultsThe five MRSA bacteraemia isolates were highly related by multilocus sequence type (ST) (four isolates were ST22 and one isolate was a single-locus variant, ST2046). Whole-genome sequencing demonstrated unequivocally that the bacteraemia cases were unrelated. Placing the MRSA bacteraemia isolates within a local and global phylogenetic tree of MRSA ST22 genomes demonstrated that the five bacteraemia isolates were highly diverse. This was consistent with the acquisition and importation of MRSA from the wider referral network. Analysis of MRSA carriage and disease in patients within the hepatology service demonstrated a higher risk of both initial MRSA acquisition compared with the nephrology service and a higher risk of progression from MRSA carriage to bacteraemia, compared with patients in nephrology or geriatric services. A root cause analysis failed to reveal any mechanism by which three of five MRSA bacteraemia episodes could have been prevented.ConclusionsThis study illustrates the complex nature of MRSA carriage and bacteraemia in patients in a specialized hepatology unit. Despite numerous ongoing interventions to prevent MRSA bacteraemia in healthcare settings, these are unlikely to result in a zero incidence in referral centres that treat highly complex patients.

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Clinical significance of Staphylococcus aureus bacteremia in patients with liver cirrhosis

Cited by 17 publications

References 21 publications

Clinical and microbiological factors associated with early patient mortality from methicillin-resistant Staphylococcus aureus bacteremia

Clinical and microbiological factors associated with early patient mortality from methicillin-resistant Staphylococcus aureus bacteremia

Bloodstream Infection with Extended-spectrum Beta-lactamase–producingEscherichia coli: the role of virulence genes

Zero tolerance for healthcare-associated MRSA bacteraemia: is it realistic?

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