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Staphylococcus aureus Bloodstream Infection and Endocarditis--A Prospective Cohort Study
Vincent Le Moing1, François Alla2, Thanh Doco-Lecompte3
1Maladies infectieuses, CHU de Montpellier, UMI 233 Université Montpellier 1, Institut de Recherche pour le Développement, Montpellier, France.
Plos One
|May 29, 2015
Summary
Staphylococcus aureus bloodstream infection (SAB) remains a severe, healthcare-associated disease. Infective endocarditis (IE) is the most common complication, often occurring in patients without prior risk factors.
Area of Science:
- Infectious Diseases
- Epidemiology
- Clinical Microbiology
Background:
- Staphylococcus aureus bloodstream infection (SAB) is a significant cause of morbidity and mortality.
- Understanding the epidemiology of SAB and its complications, such as infective endocarditis (IE), is crucial for public health.
- Previous studies have highlighted the severity of SAB, but updated epidemiological data, particularly in high-income countries, is needed.
Purpose of the Study:
- To provide updated epidemiological data on Staphylococcus aureus bloodstream infection (SAB) in a high-income country.
- To investigate the association between SAB and infective endocarditis (IE).
- To identify risk factors and outcomes associated with SAB and IE.
Main Methods:
- Prospective enrollment of 2008 adult patients with incident SAB across 8 university hospitals in France between 2009 and 2011.
- Data collection included SAB acquisition source (nosocomial, healthcare-related, community-acquired), methicillin resistance, and deep infection focus.
- Statistical analysis was performed to determine incidence, associated factors, and mortality rates.
Main Results:
- SAB was predominantly nosocomial (54%), with 19% of isolates being methicillin-resistant.
- Infective endocarditis (IE) was the most frequent deep infection focus (11%), observed in patients with and without traditional risk factors.
- Higher rates of IE were associated with community-acquired or non-nosocomial healthcare-related SAB, S. aureus meningitis, persistent bacteremia, and elevated C-reactive protein levels. Mortality was significantly higher in patients with IE (35%) compared to those without (24%).
Conclusions:
- Staphylococcus aureus bloodstream infection (SAB) continues to be a severe, largely healthcare-related disease in high-income settings.
- Infective endocarditis (IE) is the most common severe complication of SAB and frequently occurs in individuals without predisposing conditions.
- The findings underscore the need for continued vigilance and improved prevention and management strategies for SAB and its complications.
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