Clonal Complex 398 methicillin-susceptible Staphylococcus aureus bloodstream infections are associated with high mortality.
Clin Microbiol Infect. 2016 Feb 3;
Authors: Bouiller K, Gbaguidi-Haore H, Hocquet D, Cholley P, Bertrand X, Chirouze C
Abstract
Within the last decade methicillin-resistant Staphylococcus aureus belonging to CC398 has become a worldwide threat associated with livestock. More recently, methicillin-susceptible Staphylococcus aureus (MSSA) belonging to CC398 have been increasingly reported as a cause of invasive infections in patients without livestock contact. We investigated risk factors associated with CC398 bloodstream infections (BSIs) compared with non-CC398 BSIs, with a case-control study in a French university Hospital. From January 2010 to December 2014, non-duplicate Staphylococcus aureus (SA) isolates responsible for BSIs in adult patient were typed to identify those belonging to CC398. Each adult patient with a CC398 SA BSI (cases) was matched with 2 non-CC398 SA BSI controls randomly selected based on the time at risk, the unit of hospitalization and susceptibility to methicillin. We retrospectively extracted the clinical information from electronic medical records and used conditional logistic regression for univariate and multivariate analysis. We identified 67 CC398 isolates among the 770 SA responsible for BSI in adult patients. All CC398 isolates were susceptible to methicillin. The proportion of CC398 among MSSA increased steadily from 4.6% in 2010 to 15.1% in 2013 and then stabilized at 13.8% in 2014. Factors significantly associated with CC398 MSSA BSIs were: Healthcare-associated infection (Odds ratio [OR] =3.02; 95% confidence interval [CI] 1.19-7.63), history of neurological disease (OR=2.51; 95% CI 1.13-5.65), and 30-day mortality (OR=2.44; 95% CI 1.23-4.85).
PMID: 26851655 [PubMed - as supplied by publisher]