Staphylococcus aureus bacteremia: comparison of two periods and a predictive model of mortality

• Main Authors: Lucieni de Oliveira Conterno, Sérgio Barsanti Wey, Adauto Castelo
• Format: Article
• Language: English
• Published: Elsevier
• Series: Brazilian Journal of Infectious Diseases
• Subjects: Staphylococcus aureus; bacteremia; mortality
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702002000600004&lng=en&tlng=en

Staphylococcus aureus is an important pathogen causing bacteremia, primarily affecting hospitalized patients. We studied the epidemiology of S. aureus bacteremia, comparing two periods (early and mid 1990s) and developed a predictive model of mortality. A nested case-control was done. All 251 patients over 14 years old with positive blood cultures for S. aureus were selected. MRSA (methicillin resistant S. aureus) was isolated in 63% of the cases. When comparing the two periods MRSA community-acquired bacteremia increased from 4% to 16% (p=0.01). There was no significant difference in the mortality rate between the two periods (39% and 33%, p=0.40). Intravascular catheters provoked 24% of the cases of bacteremia and were associated with the lowest rate of mortality. In a logistic regression analysis, three variables were associated with death: septic shock, source of bacteraemia and resistance to methicillin. The probability of dying among patients with MRSA and those with methicillin sensitive S. aureus bacteraemia ranged from 10% to 90% and from 4% to 76%, respectively, depending on the source of the bacteraemia and the occurrence of septic shock. The MRSA found in Brazil may be a particularly virulent strain.