Risk factors for recurrence after Staphylococcus aureus bacteraemia. A retrospective matched case-control study

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Hospital Epidemiology

Background:

• Staphylococcus aureus bacteraemia (SAB) poses a significant clinical challenge.
• Understanding recurrence risk factors is crucial for optimizing patient outcomes.
• Compliance with treatment guidelines may influence SAB recurrence rates.

Purpose of the Study:

• To identify risk factors for Staphylococcus aureus bacteraemia (SAB) recurrence.
• To audit compliance with SAB treatment guidelines in a hospital setting.

Main Methods:

• Retrospective identification of patients with recurrent SAB over 8 years.
• Matching recurrent SAB cases with non-recurrent SAB control patients.
• Analysis of treatment compliance and patient factors associated with recurrence.

Main Results:

• The overall recurrence rate for SAB was 2.1% (40/1870).
• Glycopeptide use in methicillin-sensitive SAB (MSSA) was associated with increased recurrence (p=0.015).
• SAB originating from peripheral venous catheters had lower recurrence odds (p=0.047); central line removal failure led to universal recurrence.

Conclusions:

• SAB recurrence rates are low despite suboptimal guideline adherence for treatment duration.
• Beta-lactam therapy is preferred over glycopeptides for MSSA bacteraemia to reduce recurrence.
• Source control, particularly peripheral line management, is critical in preventing SAB recurrence.