Article Figures & Tables
Figures
- Figure 1:
Selection of adult patients admitted to LHSC with S. aureus bacteremia. LHSC = London Health Sciences Centre, London, Ont.
- Figure 2:
Quarterly admissions for patients with Staphylococcus aureus bacteremia at LHSC (2008−2012). LHSC = London Health Sciences Centre, London, Ont. *p < 0.05, †p < 0.01, ‡p < 0.001 by Cochran−Armitage χ2 test for trend.
- Figure 3:
Unadjusted Kaplan–Meier survival analysis for patients with Staphylococcus aureus bacteremia during their hospital stay (A) and for 90 days following their discharge from hospital (B). The data shown is right censored, and the shaded areas represent 95% confidence intervals.
Tables
- Table 1: Characteristics of patients with Staphylococcus aureus bacteremia admitted to a regional tertiary care centre between 2008 and 2012 (n = 925)
Characteristic No. (%) of patients* Median age, yr (range) 65 (18–102) Male gender 585 (63.2) Comorbidities HIV positive or AIDS 20 (2.2) Intravenous drug use 163 (17.6) Diabetes mellitus 250 (27.0) Cardiac disease (coronary artery disease or chronic heart failure) 244 (26.3) Peripheral vascular disease 70 (7.6) Cerebrovascular disease 137 (14.8) Dementia 53 (5.7) COPD 84 (9.1) Liver disease 172 (18.6) Hepatitis B or C co-infection 54 (5.8) Cirrhosis 30 (3.2) Pre-existing renal disease 175 (18.9) Solid malignancy 171 (18.5) Leukemia and lymphoma 31 (3.4) Metastatic malignancy 77 (8.3) Infection characteristics MRSA 362 (39.1) Sepsis 642 (69.4) Dominant focus of infection Central or peripheral intravascular catheter 53 (5.8) Pneumonia 109 (11.8) Skin and soft tissue infection 175 (18.9) Other† 10 (1.1) Note: COPD = chronic obstructive pulmonary disease, MRSA = methicillin-resistant Staphylococcus aureus. *Unless otherwise indicated. †Includes foci that occur in less than 1% of cases each, such as central nervous system infection (n = 3), lung abscess (n = 3) and urinary tract infection (n = 4).
- Table 2: Clinical outcomes in patients with Staphylococcus aureus bacteremia admitted to a regional tertiary-care centre between 2008 and 2012 (n = 925)
Outcome No. (%) of patients Recurrent S. aureus bacteremia infection 189 (20.4) One recurrence 161 (17.4) Two recurrences 14 (1.5) Three or more recurrences 14 (1.5) Complicated S. aureus bacteremia 248 (26.8) Infective endocarditis 72 (7.8) Septic arthritis 28 (3.0) Deep tissue abscess 56 (6.0) Osteomyelitis Vertebral 25 (2.7) Nonvertebral (i.e., hand or foot) 6 (0.6) Epidural abscess 22 (2.4) Septic thrombophlebitis 2 (0.2) Psoas abscess 12 (1.3) Meningitis 4 (0.4) Embolic stroke 8 (0.9) Other complications* 13 (1.4) Complications during hospital stay Operative intervention 258 (27.9) Renal failure requiring dialysis 80 (8.6) Hepatic failure 23 (2.5) Prolonged ventilation (> 21 d) 58 (6.3) Clostridium difficile infection 22 (2.4) Ischemic colitis 17 (1.8) Myocardial infarction 10 (1.1) Admission to the intensive care unit 225 (24.3) All-cause mortality† 258 (27.9) In-hospital mortality 196 (21.1) Postdischarge mortality (0–30 d) 30 (3.2) Postdischarge mortality (31–90 d) 32 (3.5) Mortality after 90 d postdischarge 94 (10.2) *Includes patients with mycotic aneurysm (n = 7), empyema (n = 4) and pericarditis (n = 2). †Defined as all mortalities that occurred in hospital and up to 90 days postdischarge.
Variable Adjusted HR* (95% CI) p value Age, yr < 60 1.00 (ref) − 61–70 1.54 (0.98–2.41) 0.06 71–80 3.07 (2.04–4.62) < 0.0001 > 80 5.18 (3.54–7.57) < 0.0001 Sepsis No 1.00 (ref) − Yes 1.49 (1.08–2.06) 0.02 Admission to the intensive care unit No 1.00 (ref) − Yes 3.78 (2.85–5.02) < 0.0001 Hepatic failure No 1.00 (ref) − Yes 3.36 (1.91–5.90) < 0.0001 Operative intervention No 1.00 (ref) − Yes 0.67 (0.49–0.92) 0.01 Metastatic cancer No 1.00 (ref) − Yes 2.58 (1.77–3.75) < 0.0001 Note: CI = confidence interval, HR = hazard ratio. *Adjusted for variables listed in the table.
Variable In-hospital mortality Postdischarge mortality (90 d) Adjusted HR* (95% CI) p value Adjusted HR† (95% CI) p value Age, yr < 60 (ref) 1.00 (ref) − − − 61–70 1.24 (0.79–1.95) 0.4 − − 71–80 2.30 (1.53–3.47) < 0.0001 − − > 80 4.22 (2.89–6.17) < 0.0001 − − Methicillin resistance No − − 1.00 (ref) − Yes − − 1.74 (1.04–2.89) 0.03 Sepsis No 1.00 (ref) − − − Yes 1.44 (1.04–1.99) 0.03 − − Admission to intensive care unit No 1.00 (ref) − − − Yes 2.35 (1.78–3.11) < 0.0001 − − Hepatic failure No 1.00 (ref) − 1.00 (ref) − Yes 2.20 (1.25–3.88) 0.01 5.42 (1.60–18.35) 0.01 Prolonged ventilation > 21 d No − − − − Yes − − − − Cerebrovascular disease No − − 1.00 (ref) − Yes − − 2.16 (1.21–3.86) 0.01 COPD No − − 1.00 (ref) − Yes − − 2.43 (1.28–4.61) 0.01 Metastatic cancer No 1.00 (ref) − 1.00 (ref) − Yes 2.79 (1.90–4.10) < 0.0001 5.32 (2.80–10.07) < 0.0001 Note: CI = confidence interval, COPD = chronic obstructive pulmonary disorder, HR = hazard ratio, ref = reference. *Adjusted for age, sepsis, admission to the intensive care unit, hepatic failure and metastatic cancer. †Adjusted for methicillin resistance, hepatic failure, cerebrovascular disease, COPD and metastatic cancer.
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