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Antimicrob Agents Chemother. 2019;64(1):AAC.01656-19.

A Prospective Cohort Study of Durations of Staphylococcus aureus Bacteremia According to Different Phenotypes and a New Concept of Persistent Bacteremia.

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제1저자 강창경, 송경호 · 교신저자 정숙인, 김홍빈

소속 (16)
  1. Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
  2. Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
  3. Chonnam National University Hospital, Gwangju, Republic of Korea.
  4. Chungnam National University Hospital, Daejon, Republic of Korea.
  5. Pusan National University Hospital, Busan, Republic of Korea.
  6. Inje University Ilsan Paik Hospital, Goyang, Republic of Korea.
  7. Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea.
  8. Ehwa Womans University Hospital, Seoul, Republic of Korea.
  9. Yonsei University Wonju Severance Christian Hospital, Wonju, Republic of Korea.
  10. Seoul Metropolitan Boramae Hostpial, Seoul, Republic of Korea.
  11. Inje University Haeundae Paik Hospital, Busan, Republic of Korea.
  12. Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
  13. Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
  14. Kangwon National University Hospital, Chuncheon, Republic of Korea.
  15. Chonnam National University Hospital, Gwangju, Republic of Korea sijung@chonnam.ac.kr hbkimmd@snu.ac.kr.
  16. Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea sijung@chonnam.ac.kr hbkimmd@snu.ac.kr.

Abstract

The purpose of this study was to describe and compare the duration of Staphylococcus aureus bacteremia (SAB) according to methicillin resistance and the primary foci of infection. We also aimed to newly define persistent SAB considering these results. Nonduplicated episodes of SAB in patients aged ≥15 years from 14 hospitals in the Republic of Korea were analyzed between January 2009 and February 2018. The duration of SAB was defined as the number of days from the time of administration of an antibiotic to which the isolate was susceptible after the onset of SAB to the last day of a positive blood culture for S. aureus SAB durations were described and compared based on methicillin resistance and the primary foci of infection. Cases in the top quartile for the duration of bacteremia in the respective clinical context were classified as newly defined persistent SAB, and its association with in-hospital mortality was evaluated. A total of 1,917 cases were analyzed. The duration of SAB was longer in patients with methicillin-resistant SAB (MRSAB; n = 995) than in patients with methicillin-susceptible SAB (MSSAB; n = 922) (median duration, 1 day [interquartile range, 1 to 3 days] for MSSAB and 1 day [interquartile range, 0 to 5 days] for MRSAB; P <0.001). The duration of bacteremia was longer in patients with endocarditis and bone and joint, endovascular, and surgical site infections and was shorter in patients with skin and soft tissue infections. Newly defined persistent SAB was independently associated with in-hospital mortality (adjusted odds ratio, 1.97; 95% confidence interval, 1.54 to 2.53; P <0.001). The durations of SAB were dependent on methicillin resistance and the primary foci of infection, and considering these contexts, persistent SAB was significantly associated with in-hospital mortality.

Copyright © 2019 American Society for Microbiology.

Keywords

Staphylococcus aureusbacteremiadurationmethicillin resistanceprimary foci of infection

그 밖의 정보
출판 형태
Journal Article, Research Support, Non-U.S. Gov't
저널
Antimicrobial agents and chemotherapy · eISSN 1098-6596
전자 출판
2019-12-20
MeSH
Anti-Bacterial Agents / pharmacology · Bacteremia / microbiology · Humans · Methicillin Resistance · Methicillin-Resistant Staphylococcus aureus / drug effects / pathogenicity · Phenotype · Prospective Studies · Republic of Korea · Risk Factors · Staphylococcal Infections / drug therapy / microbiology · Staphylococcus aureus / drug effects
Substances
Anti-Bacterial Agents
참고문헌
26편