Staphylococcus aureus Bloodstream Infection and Endocarditis―A Prospective Cohort Study - Université de Rennes Access content directly
Journal Articles PLoS ONE Year : 2015

Staphylococcus aureus Bloodstream Infection and Endocarditis―A Prospective Cohort Study

Bruno Hoen

Abstract

OBJECTIVES: To update the epidemiology of S. aureus bloodstream infection (SAB) in a high-income country and its link with infective endocarditis (IE).METHODS: All consecutive adult patients with incident SAB (n = 2008) were prospectively enrolled between 2009 and 2011 in 8 university hospitals in France. RESULTS: SAB was nosocomial in 54%, non-nosocomial healthcare related in 18% and community-acquired in 26%. Methicillin resistance was present in 19% of isolates. SAB Incidence of nosocomial SAB was 0.159/1000 patients-days of hospitalization (95% confidence interval [CI] 0.111-0.219). A deep focus of infection was detected in 37%, the two most frequent were IE (11%) and pneumonia (8%). The higher rates of IE were observed in injecting drug users (IE: 38%) and patients with prosthetic (IE: 33%) or native valve disease (IE: 20%) but 40% of IE occurred in patients without heart disease nor injecting drug use. IE was more frequent in case of community-acquired (IE: 21%, adjusted odds-ratio (aOR) = 2.9, CI = 2.0-4.3) or non-nosocomial healthcare-related SAB (IE: 12%, aOR = 2.3, CI = 1.4-3.5). S. aureus meningitis (IE: 59%), persistent bacteremia at 48 hours (IE: 25%) and C-reactive protein > 190 mg/L (IE: 15%) were also independently associated with IE. Criteria for severe sepsis or septic shock were met in 30% of SAB without IE (overall in hospital mortality rate 24%) and in 51% of IE (overall in hospital mortality rate 35%).CONCLUSION: SAB is still a severe disease, mostly related to healthcare in a high-income country. IE is the most frequent complication and occurs frequently in patients without known predisposing conditions
Fichier principal
Vignette du fichier
journal.pone.0127385.PDF (238.76 Ko) Télécharger le fichier
Origin Publisher files allowed on an open archive
Loading...

Dates and versions

hal-01299980 , version 1 (29-11-2016)

Licence

Identifiers

Cite

Vincent Le Moing, François Alla, Thanh Doco-Lecompte, François Delahaye, Lionel Piroth, et al.. Staphylococcus aureus Bloodstream Infection and Endocarditis―A Prospective Cohort Study. PLoS ONE, 2015, 10 (5), pp.e0127385. ⟨10.1371/journal.pone.0127385⟩. ⟨hal-01299980⟩
420 View
310 Download

Altmetric

Share

Gmail Mastodon Facebook X LinkedIn More