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Staphylococcus aureus bacteremia in alcoholics
Klaus Kessel1, Erik Forsblom1, Eeva Ruotsalainen1
1Division of Infectious Diseases, Inflammation Center, Helsinki University Hospital, Helsinki, Finland.
Plos One
|May 21, 2024
Summary
Alcoholism significantly worsens Staphylococcus aureus bacteremia outcomes, primarily due to increased illness severity at onset. This leads to higher mortality rates in alcoholic patients compared to non-alcoholics.
Area of Science:
- Infectious Diseases
- Clinical Medicine
- Public Health
Background:
- Alcoholism is linked to higher incidence and mortality of Staphylococcus aureus bacteremia.
- Understanding the impact of alcoholism on S. aureus bacteremia progression and outcomes is crucial.
Purpose of the Study:
- To compare disease progression, treatment, and prognosis of Staphylococcus aureus bacteremia in alcoholic versus non-alcoholic patients.
- To identify factors influencing mortality in these patient groups.
Main Methods:
- Multicenter retrospective analysis of methicillin-sensitive Staphylococcus aureus bacteremia.
- Stratification of 617 patients into alcoholic (83) and non-alcoholic groups based on electronic health records.
- 90-day follow-up to assess outcomes.
Main Results:
- Alcoholic patients were younger, more often male, and had community-acquired S. aureus bacteremia.
- Higher illness severity (severe sepsis, ICU admission) and pneumonia rates were observed in alcoholics.
- Alcoholics experienced significantly higher 14, 28, and 90-day mortality rates (31% vs. 17% at 90 days).
Conclusions:
- Alcoholism deteriorates Staphylococcus aureus bacteremia prognosis, mainly through increased illness severity at onset.
- While infectious disease specialist consultation and male sex predicted reduced mortality, comorbidities predicted increased mortality in alcoholics.
- Alcoholics had less endocarditis but more pneumonia as deep infection foci.
