Community-acquired Staphylococcus aureus bacteraemia in patients who do not abuse intravenous drugs

Area of Science:

• Infectious Diseases
• Internal Medicine
• Critical Care Medicine

Background:

• Staphylococcus aureus remains a significant cause of morbidity and mortality despite medical advancements.
• Community-acquired S. aureus bacteraemia presents a serious clinical challenge, particularly in populations with low rates of intravenous drug abuse.

Purpose of the Study:

• To investigate the clinical characteristics, complications, and outcomes of community-acquired S. aureus bacteraemia.
• To identify factors associated with poor outcomes and mortality in these patients.

Main Methods:

• Prospective review of 113 patients with community-acquired S. aureus bacteraemia admitted to Groote Schuur Hospital from February 1986 to January 1991.
• Statistical analysis, including stepwise regression, to determine independent predictors of mortality.

Main Results:

• Overall mortality was 35%.
• Common complications included skin infections (22% identified source), with the source undetermined in 58% of cases.
• Independent predictors of death were confusion, acute renal failure, and shock. Almost all patients (90%) developed complications, with prolonged therapy (median 70 days) for survivors.

Conclusions:

• Community-acquired S. aureus bacteraemia is associated with high rates of complications and mortality.
• Prompt recognition and management of factors like confusion, renal failure, and shock are crucial for improving patient outcomes.