Predictive Factors for Metastatic Infection in Patients With Bacteremia Caused by Methicillin-Sensitive Staphylococcus aureus

Horino, Tetsuya; Sato, Fumiya; Hosaka, Yusuke; Hoshina, Tokio; Tamura, Kumi; Nakaharai, Kazuhiko; Kato, Takumi; Nakazawa, Yozo; Yoshida, Masaki; Hori, Seiji

doi:10.1097/maj.0000000000000350

Cited by 50 publications

(37 citation statements)

References 22 publications

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“…Previous Japanese observational studies reported an inconsistent rate of pneumonia. One observational study reported a similar rate of pneumonia (17/83, 21%)6 as that reported in the present study, but another study reported a lower rate of pneumonia (4/73, 5%) 7. In contrast, the studies of SAB that were undertaken outside of Japan generally reported a low rate of pneumonia 9, 10.…”

Section: Discussionsupporting

confidence: 75%

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Adherence rate of quality‐of‐care indicators for Staphylococcus aureus bacteremia is extremely low in Japanese emergency and critical care departments: a multicenter retrospective observational study

Miyamoto

Kato

Kitayama

et al. 2017

Acute Medicine & Surgery

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Aim Staphylococcus aureus bacteremia causes significant morbidity and mortality and requires specific management to prevent complications. Most studies evaluating quality of care have been carried out in Europe and North America, and accurate epidemiological data are lacking in Asia. We aimed to describe the epidemiology and evaluate the quality of care for S. aureus bacteremia in Japan.MethodsFrom February 2011 to January 2014, we undertook a multicenter retrospective observational study in 10 departments of emergency and critical care in Japan. We included 118 hospitalized adult patients with S. aureus bacteremia and evaluated three quality‐of‐care indicators: follow‐up blood culture, treatment duration, and echocardiography.ResultsThe mean age of the patients was 63.5 ± 17.0 years. The major source of bacteremia was pneumonia (n = 22, 19%), followed by skin and soft tissue infection (n = 18, 15%). Thirty patients (25%) died in the hospital. Follow‐up blood culture was performed in 21/112 patients (19%). The duration of antimicrobial treatment was sufficient in 49/87 patients (56%). Echocardiography for patients with clinical indication was undertaken in 39/59 patients (66%). Any of the three indicators were inadequate in 101/118 (86%).ConclusionThe rate of adequate care for S. aureus bacteremia is low in Japan. The low adherence rate for follow‐up blood culture was particularly notable. Staphylococcus aureus bacteremia can be an important target of quality improvement interventions.

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Section: Discussionsupporting

confidence: 75%

“…In Japan, there have been several small observational studies about SAB, involving fewer than 100 patients 4, 5, 6, 7. These were all single‐center, rather than multicenter studies.…”

Section: Introductionmentioning

confidence: 99%

Adherence rate of quality‐of‐care indicators for Staphylococcus aureus bacteremia is extremely low in Japanese emergency and critical care departments: a multicenter retrospective observational study

Miyamoto

Kato

Kitayama

et al. 2017

Acute Medicine & Surgery

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“…Bones, joints, the kidneys, and the lungs are common sites of metastatic infections (1), and SAB occasionally involves the eyes (2). Previous studies showed that the incidences of metastatic infections due to SAB range between 13% and 39% (3)(4)(5)(6)(7)(8)(9)(10). Searching for metastatic infections in SAB is crucial, because such infections determine the duration of antibiotic therapy required and often necessitate adjuvant therapy such as drainage or surgery (11).…”

mentioning

confidence: 99%

Incidence and Risk Factors of Ocular Infection Caused by Staphylococcus aureus Bacteremia

Jung

Lee

et al. 2016

Antimicrob Agents Chemother

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Staphylococcus aureus bacteremia (SAB) often leads to ocular infections, including endophthalmitis and chorioretinitis. However, the incidence, risk factors, and outcomes of ocular infections complicated by SAB are largely unknown. We retrospectively analyzed the incidence and risk factors of ocular involvement in a prospective cohort of patients with SAB at a tertiary-care hospital. Ophthalmologists reviewed the fundoscopic findings and classified the ocular infections as endophthalmitis or chorioretinitis. During the 5-year study period, 1,109 patients had SAB, and data for 612 (55%) who underwent ophthalmic examinations within 14 days after SAB onset were analyzed. were independent risk factors for ocular involvement. Of the 47 patients with ocular involvement who could communicate, only 17 (36%) had visual disturbances. Two-thirds of the patients with endophthalmitis (10/15 patients) were treated with intravitreal antibiotics combined with parenteral antibiotics, whereas all of the patients with chorioretinitis were treated only with systemic antibiotics. No patients became blind. Among 42 patients for whom follow-up assessments were available, the ocular lesions improved in 29 (69%) but remained the same in the others. Ocular involvement was independently associated with death within 30 days after SAB onset. Ocular involvement is not uncommon among patients with SAB. Routine ophthalmic examinations should be considered for patients with infective endocarditis or metastatic infections caused by SAB. Staphylococcus aureus bacteremia (SAB) is associated with significant morbidity and mortality rates. It often leads to metastatic infections that result in clinically significant complications. Bones, joints, the kidneys, and the lungs are common sites of metastatic infections (1), and SAB occasionally involves the eyes (2). Previous studies showed that the incidences of metastatic infections due to SAB range between 13% and 39% (3-10). Searching for metastatic infections in SAB is crucial, because such infections determine the duration of antibiotic therapy required and often necessitate adjuvant therapy such as drainage or surgery (11).Ocular involvement in SAB is a critical condition because it may cause vision loss. A few case series have described ocular involvement in SAB. Ness and Schneider reported on 3 patients with endogenous methicillin-resistant S. aureus (MRSA) endophthalmitis with poor prognoses (12), whereas another more recent report on 7 patients described better outcomes after treatment (13). To the best of our knowledge, however, there has been no study of the incidence, risk factors, and outcomes of ocular involvement in SAB. In addition, it has not yet been clearly determined whether clinicians should perform ophthalmic examinations for all patients with SAB. Therefore, we aimed to investigate the incidence and risk factors for ocular involvement in patients with SAB.(This study was presented in part at ICAAC/ICC 2015, San Diego, CA, 17 to 21 September 2015.) MATERIALS AND METHODSStudy design...

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“…Several predictive factors associated with the development of metastatic infection were identified including a delay in appropriate antimicrobial treatment of .48 hours, persistent fever for .72 hours after starting antibiotic treatment, and low C-reactive protein levels of .3 mg/dL during 2 weeks after the onset of bacteremia. 23 S. aureus colonization via nasal carriage has received attention as a source of infection in patients undergoing HD. A study conducted in Taiwan evaluated the nasal carriage of MRSA and subsequent infection among dialysis patients, health care workers, and their families within a single dialysis unit.…”

mentioning

confidence: 99%

Prevention of catheter-related bloodstream infections in patients on hemodialysis: challenges and management strategies

Soi¹,

Moore²,

Kumbar³

et al. 2016

IJNRD

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Catheter-related bloodstream infections are a significant source of morbidity and mortality in the end-stage renal disease population. Although alternative accesses to undergoing renal replacement therapy exist, many patients begin hemodialysis with a dialysis catheter due to logistic and physiologic factors involved in arteriovenous fistula creation and maturation. Colonization of catheters via skin flora leads to the production of biofilm, which acts as a reservoir for virulent bacteria. Preventative therapies center on appropriate catheter maintenance, infection control measures, and early removal of devices as patients transition to other access. Despite best efforts, when conservative measures fail to prevent infections in a high-risk population, antimicrobial lock therapy should be considered as an option to combat catheter-related bloodstream infections.

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Predictive Factors for Metastatic Infection in Patients With Bacteremia Caused by Methicillin-Sensitive Staphylococcus aureus

Cited by 50 publications

References 22 publications

Adherence rate of quality‐of‐care indicators for Staphylococcus aureus bacteremia is extremely low in Japanese emergency and critical care departments: a multicenter retrospective observational study

Adherence rate of quality‐of‐care indicators for Staphylococcus aureus bacteremia is extremely low in Japanese emergency and critical care departments: a multicenter retrospective observational study

Incidence and Risk Factors of Ocular Infection Caused by Staphylococcus aureus Bacteremia

Prevention of catheter-related bloodstream infections in patients on hemodialysis: challenges and management strategies

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