Staphylococcus aureus bacteremia: significance of hyperbilirubinemia

We studied 233 consecutive episodes of Staphylococcus aureus bacteremia in 230 patients between 1980 and 1984 at a community teaching hospital. Bacteremia was community-acquired in 78 episodes, acquired from nursing homes in 22 episodes and hospital-acquired in 133 episodes. The over-all mortality was 48.9%. Patients greater than or equal to 60 years had higher mortality (62.0%) than patients less than 60 years old (25.3%). Hospital-acquired bacteremia was associated with a higher mortality (59.4%) than community-acquired bacteremia (29.5%). The respiratory tract as the portal of entry of bacteremia was associated with a higher mortality (80.4%), as compared to 53.5% when the portal of entry was undetermined, and 28.1% when the portal of entry was other sources. Increasing serum creatinine levels were associated with increasing mortality: less than 88.4 mumol/l (26.5%), 97.2-168.0 mumol/l (51.1%), and greater than 176.8 mumol/l (67.9%). Increasing serum bilirubin levels were also associated with increasing mortality: less than 17.1 mumol/l (40.6%), 18.8-49.6 mumol/l (57.1%), and greater than 51.3 mumol/l (84.2%). Very high leukocyte counts were associated with higher mortality: greater than 20 X 10(9)/l (73.9%), 10-20 X 10(9)/l (37.4%), and less than 10 X 10(9)/l (45.8%).