Highlights
- •Staphylococcus aureus bloodstream infections in hospitalized patients are associated with significant mortality.
- •Primary Staphylococcus aureus central line–associated bloodstream infections (CLABSIs) did not differ in their mortality compared with non-CLABSIs.
- •Primary Staphylococcus aureus non–central line–associated bloodstream infections were associated with more bacteremic complications.
- •Infected peripheral intravenous catheters and midlines are the etiology of most non–central line–associated bloodstream infection Staphylococcus aureus bacteremias.
Background
This study was done to describe the incidence and outcomes of primary hospital-acquired
bloodstream infection (HABSI) secondary to Staphylococcus aureus (SA) that did and did not meet the National Healthcare Safety Network's (NHSN's)
definition for central line–associated bloodstream infection (CLABSI).
Methods
Consecutive hospitalized patients during a 48-month study period with an SA HABSI
were categorized according to those who did and did not meet the NHSN's definitions
for CLABSI and non-CLABSI. Primary outcomes were mortality at 30 days and 1 year.
Secondary outcomes were the incidence of complicated bacteremia and the need for operative
intervention secondary to the HABSI event.
Results
A total of 122 episodes of primary SA HABSIs were identified: 78 (64%) were CLABSIs,
and 44 (36%) were non-CLABSIs. Overall 30-day and 1-year mortality in the cohort was
21.3% and 38.5%, respectively, and did not differ significantly between the 2 groups.
Complicated SA HABSI was significantly more common in the non-CLABSI group (15.9%
[n = 7] vs 0% [n = 0], P ≤ .001).
Conclusions
Primary SA HABSI was associated with significant 30-day and 1-year mortality. Complications
from SA non-CLABSI requiring surgical intervention were significantly more common
than in those with a CLABSI event. Our findings affirm the significance of non–device-related
hospital-acquired infections.
Key Words
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References
- Staphylococcus aureus bacteremia, risk factors, complications, and management.Crit Care Clin. 2013; 29: 547-562
- Risk factors and mortality of healthcare-associated and community-acquired Staphylococcus aureus bacteraemia.Clin Microbiol Infect. 2012; 18: 862-869
- Diagnosis and management of catheter-related bloodstream infections due to Staphylococcus aureus.Intern Med J. 2005; 35: S45-62
- The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies.Mayo Clin Proc. 2006; 81: 1159-1171
- Peripheral venous catheter-related Staphylococcus aureus bacteremia.Infect Control Hosp Epidemiol. 2011; 32: 579-583
- CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting.Am J Infect Control. 2008; 36: 309-332
- Persistence in Staphylococcus aureus bacteremia: incidence, characteristics of patients and outcome.Scand J Infect Dis. 2006; 38: 7-14
- Staphylococcus aureus bacteremia: predictors of 30-day mortality in a large cohort.Clin Infect Dis. 2000; 31: 1170-1174
- Healthcare-associated vs. hospital-acquired Staphylococcus aureus bacteremia.Int J Infect Dis. 2012; 16: e457-63
- Peripheral intravenous catheter-associated Staphylococcus aureus bacteraemia: more than 5 years of prospective data from two tertiary health services.Med J Aust. 2013; 198: 551-553
- Staphylococcus aureus bacteremia. Current clinical patterns.Am J Med. 1976; 60: 495-500
- Risk factors for hematogenous complications of intravascular catheter-associated Staphylococcus aureus bacteremia.Clin Infect Dis. 2005; 40: 695-703
- Clinical epidemiology and outcomes of peripheral venous catheter-related bloodstream infections at a university-affiliated hospital.J Hosp Infect. 2007; 67: 22-29
- Guidelines for the prevention of intravascular catheter-related infections.Am J Infect Control. 2011; 39: S1-34
- Strategies to prevent central line-associated bloodstream infections in acute care hospitals: 2014 update.Infect Control Hosp Epidemiol. 2014; 35: S89-107
- Multistate point-prevalence survey of health care-associated infections.N Engl J Med. 2014; 370: 1198-1208
- Intravenous catheter infections associated with bacteraemia: a 2-year study in a university hospital.Clin Microbiol Infect. 2004; 10: 431-435
- The risk of midline catheterization in hospitalized patients. A prospective study.Ann Intern Med. 1995; 123: 841-844
- Routine versus clinically indicated replacement of peripheral intravenous catheters: a randomised controlled equivalence trial.Lancet. 2012; 380: 1066-1074
- CLABSI rates in immunocompromised patients: a valuable patient centered outcome?.Clin Infect Dis. 2011; 52: 1446-1450
Article Info
Publication History
Published online: May 05, 2016
Footnotes
Conflicts of Interest: None to report.
Identification
Copyright
© 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
