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High mortality impact of Staphylococcus argenteus on patients with community-onset staphylococcal bacteraemia.
Int J Antimicrob Agents. 2018 Aug 24;:
Authors: Chen SY, Lee H, Wang XM, Lee TF, Liao CH, Teng LJ, Hsueh PR
Abstract
Staphylococcus argenteus has been increasingly reported. Evaluating the impact of S. argenteus infections on patient outcomes for future therapeutic and infection control decision-making is imperative. We conducted a retrospective study to investigate the prevalence of S. argenteus bacteraemia at a medical centre between 2010 and 2012. S. argenteus was identified based on the absence of the crtM gene and multilocus sequence analysis (MLST). The clinical characteristics between S. argenteus and S. aureus bacteraemia were compared. The independent effect of S. argenteus on bacteraemia mortality was evaluated. A total of 47 S. argenteus isolates were re-identified from 394 S. aureus bacteraemia isolates. All S. argenteus isolates were susceptible to methicillin and multiple other antibiotics. Most of the S. argenteus (36/47, 76.6%) isolates were ST 2550. Comparing the 47 S. argenteus bacteraemia cases with the 232 methicillin-susceptible S. aureus (MSSA) bacteraemia cases, S. argenteus bacteraemia patients had significantly higher percentages of polymicrobial infection, recent hospitalization in the past 3 months, thrombocytopenia, lower respiratory tract infection and short-term mortality. Compared to MSSA bacteraemia, S. argenteus bacteraemia was independently associated with an increased risk of mortality (adjusted hazard ratio [aHR], 1.845; 95% confidence interval [CI], 1.033-3.294) using multivariate Cox regression analysis. In a stratified analysis, S. argenteus bacteraemia was associated with higher mortality risk than MSSA bacteraemia among patients with prior healthcare-associated exposure (aHR, 2.769; 95% CI, 1.489-5.149). Though more susceptible to multiple antibiotics, S. argenteus bacteraemia cases were independently associated with higher mortality than those with MSSA bacteraemia.
PMID: 30149137 [PubMed - as supplied by publisher]