Hospital-acquired Staphylococcus aureus primary bloodstream infection: A comparison of events that do and do not meet the central line–associated bloodstream infection definition


      • 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.


      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).


      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.


      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).


      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.

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