Risk Factors and Mortality of Health Care-Associated and Community Acquired Staphylococcus aureus Bacteremia - Bassetti - Clinical Microbiology and Infection - Wiley Online Library.
SAB was diagnosed in 165 patients over the study period (January 2007-December 2007). Five variables were independently associated with HCA ≥ 48 h SAB: presence of central venous catheter, solid tumor, chronic renal failure, previous hospitalization, and previous antibiotic therapy. Significant risk factors for HCA < 48h SAB were: Charlson Comorbidity Index ≥ 3, prior hospitalization, provenience from long term care facilities, and corticosteroid therapy. Factors independently associated with CA SAB were: diabetes mellitus, Human Immunodeficiency Virus (HIV) infection, and chronic live disease. Patients with HCA < 48 h SAB were significantly more likely to receive initial inadequate antimicrobial treatment (IIAT) than patients with CA or HCA ≥ 48 h SAB (44.8% versus 33.3% and 31.5%, respectively). Logistic-regression analysis identified 3 variables as independent predictors of mortality: presentation with septic shock, infection due to methicillin-resistant S. aureus, and IIAT. More than one half of patients with SAB has MRSA strains and presentation with septic shock, and inappropriate empirical therapy was associated with increased mortality.
