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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Clinical characteristics and risk factors of polymicrobial Staphylococcus aureus bloodstream infections
Cheng Zheng1,2, Shufang Zhang3, Qingqing Chen4
1Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China.
Background:
Although Staphylococcus aureus bloodstream infections (SA-BSI) are a common and important infection, polymicrobial SA-BSI are infrequently reported. The aim of this study was to investigate the clinical characteristics and risk factors of polymicrobial SA-BSI in comparison with monomicrobial SA-BSI.
Methods:
A single-center retrospective observational study was performed between Jan 1, 2013, and Dec 31, 2018 at a tertiary hospital. All patients with SA-BSI were enrolled, and their clinical data were gathered by reviewing electronic medical records.
Results:
A total of 349 patients with SA-BSI were enrolled including 54 cases (15.5%) with polymicrobial SA-BSI. In multivariable analysis, burn injury (adjusted odds ratio [OR], 7.04; 95% confidence interval [CI], 1.71-28.94), need of blood transfusion (aOR, 2.72; 95% CI, 1.14-6.50), use of mechanical ventilation (aOR, 3.11; 95% CI, 1.16-8.30), the length of prior hospital stay (aOR, 1.02; 95% CI, 1.00-1.03), and pneumonia as primary site of infection (aOR, 4.22; 95% CI, 1.69-10.51) were independent factors of polymicrobial SA-BSI. In comparison with monomicrobial SA-BSI, patients with polymicrobial SA-BSI had longer length of ICU stay [median days, 23(6.25,49.25) vs. 0(0,12), p < 0.01] and hospital stay [median days, 50(21.75,85.75) vs. 28(15,49), p < 0.01], and showed a higher 28-day mortality (29.6% vs. 15.3%, p = 0.01).
Conclusions:
Burn injury, blood transfusion, mechanical ventilation, the length of prior hospital stay, and pneumonia as a primary site of infection are independent risk factors for polymicrobial SA-BSI. In addition, patients with polymicrobial SA-BSI might have worse outcomes compared with monomicrobial SA-BSI.
Insights
Polymicrobial Staphylococcus aureus bloodstream infections (SA-BSI) are associated with specific risk factors including burn injury and mechanical ventilation. These infections lead to longer hospital stays and increased mortality compared to monomicrobial SA-BSI.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Epidemiology
Background:
- Staphylococcus aureus bloodstream infections (SA-BSI) are common.
- Polymicrobial SA-BSI are infrequently reported, necessitating further investigation.
- Understanding polymicrobial SA-BSI is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the clinical characteristics of polymicrobial SA-BSI.
- To identify risk factors associated with polymicrobial SA-BSI.
- To compare outcomes of polymicrobial SA-BSI with monomicrobial SA-BSI.
Main Methods:
- Retrospective observational study conducted at a tertiary hospital from 2013-2018.
- Inclusion of all patients diagnosed with SA-BSI.
- Data collection through electronic medical records review.
Main Results:
- Out of 349 SA-BSI cases, 15.5% were polymicrobial.
- Independent risk factors for polymicrobial SA-BSI included burn injury, blood transfusion, mechanical ventilation, prolonged prior hospital stay, and pneumonia.
- Polymicrobial SA-BSI patients experienced significantly longer ICU and hospital stays and higher 28-day mortality.
Conclusions:
- Burn injury, blood transfusion, mechanical ventilation, prior hospital stay length, and pneumonia are key risk factors for polymicrobial SA-BSI.
- Polymicrobial SA-BSI is associated with worse clinical outcomes compared to monomicrobial SA-BSI.
- These findings highlight the importance of recognizing and managing polymicrobial SA-BSI.
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