Staphylococcus aureus Bloodstream Infection and Endocarditis--A Prospective Cohort Study

Vincent Le Moing, François Alla, Thanh Doco-Lecompte, François Delahaye, Lionel Piroth, Catherine Chirouze, Pierre Tattevin, Jean-Philippe Lavigne, Marie-Line Erpelding, Bruno Hoen, François Vandenesch, Xavier Duval, VIRSTA study group, Catherine Chirouze, Elodie Curlier, Cécile Descottes-Genon, Bruno Hoen, Isabelle Patry, Lucie Vettoretti, Pascal Chavanet, Jean-Christophe Eicher, Sandrine Gohier-Treuvelot, Marie-Christine Greusard, Catherine Neuwirth, André Péchinot, Lionel Piroth, Marie Célard, Catherine Cornu, François Delahaye, Malika Hadid, Pascale Rausch, Audrey Coma, Florence Galtier, Philippe Géraud, Hélène Jean-Pierre, Vincent Le Moing, Catherine Sportouch, Jacques Reynes, Nejla Aissa, Thanh Doco-Lecompte, François Goehringer, Nathalie Keil, Lorraine Letranchant, Hepher Malela, Thierry May, Christine Selton-Suty, Nathalie Bedos, Jean-Philippe Lavigne, Catherine Lechiche, Albert Sotto, Xavier Duval, Emila Ilic Habensus, Bernard Iung, Catherine Leport, Pascale Longuet, Raymond Ruimy, Eric Bellissant, Pierre-Yves Donnio, Fabienne Le Gac, Christian Michelet, Matthieu Revest, Pierre Tattevin, Elise Thebault, François Alla, Pierre Braquet, Marie-Line Erpelding, Laetitia Minary, Sarah Tubiana, Michèle Bès, Jérôme Etienne, Anne Tristan, François Vandenesch, Sandrine Barbas, Christine Delonca, Virginie Sussmuth, Anne Verchère, Vincent Le Moing, François Alla, Thanh Doco-Lecompte, François Delahaye, Lionel Piroth, Catherine Chirouze, Pierre Tattevin, Jean-Philippe Lavigne, Marie-Line Erpelding, Bruno Hoen, François Vandenesch, Xavier Duval, VIRSTA study group, Catherine Chirouze, Elodie Curlier, Cécile Descottes-Genon, Bruno Hoen, Isabelle Patry, Lucie Vettoretti, Pascal Chavanet, Jean-Christophe Eicher, Sandrine Gohier-Treuvelot, Marie-Christine Greusard, Catherine Neuwirth, André Péchinot, Lionel Piroth, Marie Célard, Catherine Cornu, François Delahaye, Malika Hadid, Pascale Rausch, Audrey Coma, Florence Galtier, Philippe Géraud, Hélène Jean-Pierre, Vincent Le Moing, Catherine Sportouch, Jacques Reynes, Nejla Aissa, Thanh Doco-Lecompte, François Goehringer, Nathalie Keil, Lorraine Letranchant, Hepher Malela, Thierry May, Christine Selton-Suty, Nathalie Bedos, Jean-Philippe Lavigne, Catherine Lechiche, Albert Sotto, Xavier Duval, Emila Ilic Habensus, Bernard Iung, Catherine Leport, Pascale Longuet, Raymond Ruimy, Eric Bellissant, Pierre-Yves Donnio, Fabienne Le Gac, Christian Michelet, Matthieu Revest, Pierre Tattevin, Elise Thebault, François Alla, Pierre Braquet, Marie-Line Erpelding, Laetitia Minary, Sarah Tubiana, Michèle Bès, Jérôme Etienne, Anne Tristan, François Vandenesch, Sandrine Barbas, Christine Delonca, Virginie Sussmuth, Anne Verchère

Abstract

Objectives: To update the epidemiology of S. aureus bloodstream infection (SAB) in a high-income country and its link with infective endocarditis (IE).

Methods: All consecutive adult patients with incident SAB (n = 2008) were prospectively enrolled between 2009 and 2011 in 8 university hospitals in France.

Results: SAB was nosocomial in 54%, non-nosocomial healthcare related in 18% and community-acquired in 26%. Methicillin resistance was present in 19% of isolates. SAB Incidence of nosocomial SAB was 0.159/1000 patients-days of hospitalization (95% confidence interval [CI] 0.111-0.219). A deep focus of infection was detected in 37%, the two most frequent were IE (11%) and pneumonia (8%). The higher rates of IE were observed in injecting drug users (IE: 38%) and patients with prosthetic (IE: 33%) or native valve disease (IE: 20%) but 40% of IE occurred in patients without heart disease nor injecting drug use. IE was more frequent in case of community-acquired (IE: 21%, adjusted odds-ratio (aOR) = 2.9, CI = 2.0-4.3) or non-nosocomial healthcare-related SAB (IE: 12%, aOR = 2.3, CI = 1.4-3.5). S. aureus meningitis (IE: 59%), persistent bacteremia at 48 hours (IE: 25%) and C-reactive protein > 190 mg/L (IE: 15%) were also independently associated with IE. Criteria for severe sepsis or septic shock were met in 30% of SAB without IE (overall in hospital mortality rate 24%) and in 51% of IE (overall in hospital mortality rate 35%).

Conclusion: SAB is still a severe disease, mostly related to healthcare in a high-income country. IE is the most frequent complication and occurs frequently in patients without known predisposing conditions.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. Thwaites GE, Edgeworth JD, Gkrania-Klostas E, Kirby A, Tilley R, Török ME et al. Clinical management of Staphylococcus aureus bacteraemia. Lancet Infect Dis 2011;11:208–222. 10.1016/S1473-3099(10)70285-1
    1. Laupland KB. Incidence of bloodstream infection: a review of population-based studies. Clin Microbiol Infect 2013;19:492–500. 10.1111/1469-0691.12144
    1. Asgeirsson H, Gudlaugsson O, Kristinsson KG, Heiddal S, Kristjansson M. Staphylococcus aureus bacteraemia in Iceland, 1995–2008: changing incidence and mortality. Clin Microbiol Infect 2011;17:513–518. 10.1111/j.1469-0691.2010.03265.x
    1. Benfield T, Espersen F, Frimodt-Moller, Jensen AG, Larsen AR, Pallesen LV et al. Increasing incidence but decreasing in-hospital mortality of adult Staphylococcus aureus bacteraemia between 1981 and 2000. Clin Microbiol Infect 2007;13:257–263.
    1. El-Atrouni W, Knoll BM, Lahr BD, Eckel-Passow JE, Sia IG, Baddour LM. Temporal trends in the incidence of Staphylococcus aureus bacteremia in Olmsted County, Minnesota, 1998 to 2005: a population-based study. Clin Infect Dis 2009;49:e130–e138. 10.1086/648442
    1. van Hal SJ, Jensen SO, Vaska VL, Espedido BA, Peterson BL, Gosbell IB. Predictors of mortality in Staphylococcus aureus bacteremia. Clin Microbiol Rev 2012;25:362–386. 10.1128/CMR.05022-11
    1. Laupland KB, Ross T, Gregson DB. Staphylococcus aureus bloodstream infections: risk factors, outcomes, and the influence of methicillin resistance in Calgary, Canada, 2000–2006. Clin Infect Dis 2008;198:336–343.
    1. Khatib R, Sharma M, Iyer S, Fakih MG, Obeid KM, Venugopal A et al. Decreasing incidence of Staphylococcus aureus bacteremia over 9 years: greatest decline in community-associated methicillin-susceptible and hospital-acquired methicillin-resistant isolates. Am J Infect Control 2013;41:210–213. 10.1016/j.ajic.2012.03.038
    1. Rasmussen RV, Host U, Arpi M, Hassager C, Johansen HK, Korup E et al. Prevalence of infective endocarditis in patients with Staphylococcus aureus bacteraemia: the value of screening with echocardiography. Eur J Echocardiogr 2011;12:414–420. 10.1093/ejechocard/jer023
    1. Forsblom E, Ruotsalainen E, Molkanen T, Ollgren J, Lyytikainen O, Jarvinen A. Predisposing factors, disease progression and outcome in 430 prospectively followed patients of healthcare- and community-acquired Staphylococcus aureus bacteraemia. J Hosp Infect 2011;78:102–107. 10.1016/j.jhin.2011.03.010
    1. Finkelstein R, Agmon Y, Braun E, Kassis I, Sprecher H, Raz A et al. Incidence and risk factors for endocarditis among patients with health care-associated Staphylococcus aureus bacteraemia. Scand J Infect Dis 2012:934–940. 10.3109/00365548.2012.707331
    1. Kaasch AJ, Barlow G, Edgeworth JD, Fowler VG, Hellmich M, Hopkins S et al. Staphyloocccus aureus bloodstrem infection: a pooled analysis of five prospective, observational studies. J Infect 2014; 68:242–51. 10.1016/j.jinf.2013.10.015
    1. Fowler VG, Miro JM, Hoen B, Cabell CH, Abrutyn E, Rubinstein E et al. Staphylococcus aureus endocarditis. A consequence of medical progress. JAMA 2005;293:3012–3021.
    1. Selton-Suty C, Célard M, Le Moing V, Doco-Lecompte T, Chirouze C, Iung B et al. Preeminence of Staphylococcus aureus in infective endocarditis: a 1-year population-based survey. Clin Infect Dis 2012;54:1230–1239. 10.1093/cid/cis199
    1. Hoen B, Duval X. Clinical practice: infective endocarditis. N Engl J Med 2013;368:1425–1433. 10.1056/NEJMcp1206782
    1. Duval X, Alla F, Doco-Lecompte T, Le Moing V, Delahaye F, Mainardi JL et al. Diabetes mellitus and infective endocarditis: the insulin factor in patient morbidity and mortality. Eur Heart J 2007;28:59–64.
    1. del Rio A, Cervera C, Moreno A, Moreillon P, Miro JM. Patients at risk of complications of Staphylococcus aureus bloodstream infection. Clin Infect Dis 2009:48:S246–S253. 10.1086/598187
    1. Kang DH, Kim YJ, Kim SH, Sun BJ, Kim DH, Yun SC et al. Early surgery versus conventional treatment for infective endocarditis. N Engl J Med 2012;366:2466–2473. 10.1056/NEJMoa1112843
    1. Joseph JP, Meddows TR, Webster DP, Newton JD, Myerson SG, Prendergast B et al. Prioritizing echocardiography in Staphylococcus aureus bactereamia. J Antimicrob Chemother 2013;68:444–449. 10.1093/jac/dks408
    1. Vos FJ, Bleeker-Rovers CP, Sturm PD, Krabbe PFM, van Dijk APJ, Oyen WJG et al. Endocarditis: effects of routine echocardiography during Gram-positive bacteraemia. Neth J Med 2011:69:335–340.
    1. van Hal SJ, Mathur G, Kelly J, Aronis C, Cranney GB, Jones PD. The role of transthoracic echocardiography in excluding left sided infective endocarditis in Staphylococcus aureus bacteraemia. J Infect 2005;51:218–221.
    1. Li J, Sexton DJ, Mick N, Nettles R, Fowler VG, Ryan T et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis 2000;30:633–638.
    1. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP and the Strobe Initiative. The Strenghthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines of reporting observational studies. Lancet 2007;370:1453–1457.
    1. Fowler VG, Olsen MK, Corey GR, Woods CW, Cabell CH, Reller LB et al. Clinical identifiers of complicated Staphylococcus aureus bacteremia. Arch Intern Med 2003;163:2066–2072.
    1. Chang FY, MacDonald BB, Peacock JE, Musher DM, Triplett P, Mylotte JM et al. A prospective multicenter study of Staphylococcus aureus bacteremia. Incidence of endocarditis, risk factors for mortality and clinical impact of methicillin resistance. Medicine (Baltimore) 2003;82:322–332.
    1. Robicsek A, Beaumont JL, Paule SM, Hacek DM, Thomson RB, Kaul KL et al. Universal surveillance for methicillin-resistant Staphyloccus aureus in 3 affiliated hospitals. Ann Intern Med 2008;148:409–418.
    1. Ammerlaan HSM, Harbartth S, Buiting AGM, Crook DW, Fitzpatrick F, Hanberger H et al. Secular trends in nosocomial infections: antibiotic-resistant bacteria increase the total burden of infection. Clin Infect Dis 2013;56:798–805. 10.1093/cid/cis1006
    1. Mitchell BG, Collignon PJ, McCann R, Wilkinson IJ, Wells A. A major reduction in hospital-onset Staphylococcus aureus bacteremia in Australia- 12 years of progress: an observational study. Clin Infect Dis 2014;59:969–975. 10.1093/cid/ciu508
    1. Huang SS, Septimus E, Kleinman K, Moody J, Hickock J, Avery TR et al. Targeted versus universal decontamination to prevent ICU infections. N Engl J Med 2013;368:2255–2265. 10.1056/NEJMoa1207290
    1. Climo MW, Yokoe DS, Warren DK, Perl TM, Bolon M, Herwaldt LA et al. Effect of daily chlorhexidine bathing on hospital-acquired infections. N Engl J Med 2013;368:533–542. 10.1056/NEJMoa1113849
    1. Bayer AS, Lam K, Ginzton L, Norman DC, Chiu CY, Ward JI. Staphylococcus aureus bacteremia. Clinical, serologic, and echocardiographic findings in patients with and without endocarditis. Arch Intern Med 1987;147:457–462.
    1. El-Ahdab F, Benjamin DK, Wang A, Cabell CH, Chu VH, Stryjewski ME et al. Risk of endocarditis among patients with prosthetic valves and Staphylococcus aureus bacteremia. Am J Med 2005;118:225–229.
    1. Hill EE, Vanderschueren S, Verhaegen J, Herijgers P, Claus P, Herregods MC et al. Risk factors for infective endocarditis and outcome of patients with Staphylococcus aureus bacteremia. Mayo Clin Proc 2007;82:1165–1169.
    1. Fowler VG, Nelson CL, McIntyre LM, Kreiswirth BN, Monk A, Archer GL et al. Potential associations between hematogenous complications and bacterial genotype in Staphylococcus aureus infection. J Infect Dis 2007;196:738–747.
    1. Tristan A, Rasigade JP, Ruizendaal E, Laurent F, Bes M, Meugnier H et al. Rise of CC-398 lineage of Staphylococcus aureus among infective endocarditis isolates revealed by two consecutive population-based studies in France. Plos One 2012;7:e51172 10.1371/journal.pone.0051172
    1. Nethercott C, Mabbett AN, Totsika M, Peters P, Ortiz JC, Nimmo JR et al. Molecular characterization of endocarditis-associated Staphylococcus aureus . J Clin Microbiol 2013;51:2131–2138. 10.1128/JCM.00651-13
    1. Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I et al. Guidelines on the prevention, diagnosis and treatment of infective endocarditis. Eur Heart J 2009;30:2369–2413. 10.1093/eurheartj/ehp285

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다