Reduced Mortality of Staphylococcus aureus Bacteremia in a Retrospective Cohort Study of 2139 Patients: 2007–2015

Abstract

Background Understanding the changing epidemiology of Staphylococcus aureus bacteremia, as well as the variables associated with poor outcomes, can yield insight into potential interventions. Methods This study was a retrospective, observational cohort study of adult patients at an academic medical center in New York City who had S. aureus bloodstream infections between 1 January 2007 and 31 December 2015. Participants were divided into 3 periods: group 1 (2007–2009), group 2 (2010–2012), and group 3 (2013–2015) for trend analysis. All clinical strains were genotyped (spa.). The main outcome was 30-day all-cause mortality. Results There were 1264 episodes of methicillin-susceptible S. aureus (MSSA) and 875 episodes of methicillin-resistant S. aureus (MRSA) bacteremia, with a rising proportion due to MSSA (55% group 1; 59% group 2; 63% group 3; P = .03.) There were no significant changes in average age, gender, Charlson score, and distribution of strain genotypes. Mortality in MRSA infection was unchanged (25% group 1; 25% group 2; 26% group 3), while mortality in MSSA infection significantly declined (18% group 1; 18% group 2; 13% group 3). The average time to antistaphylococcal therapy (AST) in MSSA infection declined during the study (3.7 days group 1; 3.5 group 2; 2.2 group 3). In multivariate analysis, AST within 7 days of initial positive MSSA culture was associated with survival. Conclusions Mortality in MSSA bloodstream infection is declining, associated with a decrease in time to targeted therapy. These results emphasize the potential for rapid diagnostics and early optimization of treatment to impact outcomes in MSSA bacteremia.

Staphylococcus aureus bacteremia and cardiac implantable electronic devices in a county hospital setting: a population-based retrospective cohort study

“…During the study, the prognosis for patients improved substantially ( Figure 4a ), consistent with previous findings for SAB ( 24 ), S. aureus IE ( 25 ), and sepsis cohorts ( 26 – 28 ). There are probably several explanations for this.…”

“…Changes in population characteristics might have contributed, even though the relative importance of such factors seems to be less pronounced as no significant linear association between age, NEWS2 score, CCS, nursing home residential status, community acquisition, lead dwelling time and type of CIED with time could be detected (Supplementary Figures 2 and 3). Improvements in different SAB care processes, not analyzed specifically here – for instance, increased sepsis awareness, standardization of management ( 29 ), a shortened time to antistaphylococcal therapy ( 24 ), and improvements in intensive care management ( 28 ) were likely to be essential factors in explaining the observed improvements seen in prognosis.…”

Antimicrobial Resistance and Molecular Epidemiology of Staphylococcus aureus Causing Bloodstream Infections at Ruijin Hospital in Shanghai from 2013 to 2018

“…In addition, chronic lung disease, previous hospitalization and older patients (>79 years) are related with increased mortality as well 23 . The mortality in MSSA infections significantly declined and the average time to anti-staphylococcal therapy in MSSA infections decreased even though the mortality in MRSA infections was unchanged 25 . The declining mortality in MSSA infections might be related to the reduction in the duration of targeted therapy.…”

The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of silver nanoparticles against Staphylococcus aureus

“…It is responsible for a variety of human infections including superficial lesions in the skin and localized abscesses, central nervous system infections, osteomyelitis, invasive endocarditis, septic arthritis, septicemia, pneumonia, and urinary tract infections [ 5 ]. Mortality due to bacteremia caused by S. aureus is between 13% and 26% [ 6 ].…”