Factors associated with mortality in Staphylococcus aureus bacteremia: the role of infectious diseases consultation

Abstract

This study aimed to determine the predictors of 14th and 28th day mortality in Staphylococcus aureus bacteremia and to evaluate the risk factors of methicillin-resistant S. aureus (MRSA). Our study, designed as a single-center retrospective observational study, included adult patients (> 18 years) who developed S. aureus bacteremia. Patients with intensive care unit (ICU)-onset bacteremia were excluded to evaluate a more homogenous, ward-based population. This study evaluated SAB to identify predictors of 14-day and 28-day mortality. Collected data included demographic data, comorbidities (modified Charlson Comorbidity Index [CCI]), clinical scores (Pitt Bacteremia Score), and laboratory parameters (including lymphocyte counts, platelet counts, and lactate dehydrogenase [LDH]). 266 patients were included in the study. In multivariate Cox regression analysis for 14-day mortality, evaluation of patients by an Infectious Diseases (ID) Specialist and removal of the central venous catheter (CVC) were found to be independently associated with increased survival while modified CCI scores were associated with increased mortality. In the multivariate Cox regression analysis for 28-day mortality, evaluation by the ID consultation and removal of the central venous catheter were independently associated with a lower risk of mortality, while the modified CCI scores and LDH levels were associated with increased mortality. In this study, a high modified CCI score was shown to indicate a poor prognosis in SAB. However, our findings suggest that ID specialist consultation and prompt CVC removal are independently associated with a lower risk of mortality.