Staphylococcus aureus bloodstream infections in Latin America: results of a multinational prospective cohort study.
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ABSTRACT:
SUBMITTER: Seas C
PROVIDER: S-EPMC5890709 | biostudies-literature | 2018 Jan
REPOSITORIES: biostudies-literature
Publications
Staphylococcus aureus bloodstream infections in Latin America: results of a multinational prospective cohort study.
Seas Carlos C Garcia Coralith C Salles Mauro J MJ Labarca Jaime J Luna Carlos C Alvarez-Moreno Carlos C Mejía-Villatoro Carlos C Zurita Jeannete J Guzmán-Blanco Manuel M Rodríguez-Noriega Eduardo E Reyes Jinnethe J Arias Cesar A CA Carcamo Cesar C Gotuzzo Eduardo E
The Journal of antimicrobial chemotherapy 20180101 1
<h4>Background</h4>Substantial heterogeneity in the epidemiology and management of Staphylococcus aureus bacteraemia (SAB) occurs in Latin America. We conducted a prospective cohort study in 24 hospitals from nine Latin American countries.<h4>Objectives</h4>To assess the clinical impact of SAB in Latin America.<h4>Patients and methods</h4>We evaluated differences in the 30 day attributable mortality among patients with SAB due to MRSA compared with MSSA involving 84 days of follow-up. Adjusted r ...[more]
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Project description:BackgroundThe presence of Staphylococcus aureus in the bloodstream can lead to the development of sepsis; however, the severity and risk factors of the systemic inflammatory response to Staphylococcus aureus bloodstream infections were unclear. This study is aimed to build a model to predict the risk of sepsis in children with Staphylococcus aureus bloodstream infections.MethodsA retrospective analysis of hospitalized pediatric patients diagnosed with Staphylococcus aureus bloodstream infections was performed between January 2013 and December 2019. Each patient was assessed using the pediatric version of the Sequential Organ Failure Assessment score (pSOFA) within 24 h of blood culture collection. A nomogram based on logistic regression models was constructed to predict the risk factors for sepsis in children with Staphylococcus aureus bloodstream infections. It was validated using the area under the receiver-operating characteristic curve (AUC).ResultsOf the 94 patients included in the study, 35 cases (37.2%) developed sepsis. The pSOFA scores ranged from 0 to 8, with 35 patients having a pSOFA score of ≥ 2. Six children (6.4%) died within 30 days, who were all from the sepsis group and had different pSOFA scores. The most common organs involved in sepsis in children with staphylococcal bloodstream infections were the neurologic system (68.6%), respiratory system (48.6%), and coagulation system (45.7%). Hospital-acquired infections (adjusted odds ratio [aOR], 3.0; 95% confidence interval [CI], 1.3-7.2), implanted catheters (aOR, 10.4; 95% CI, 3.8-28.4), procalcitonin level ≥ 1.7 ng/mL (aOR, 15.4; 95% CI, 2.7-87.1), and underlying diseases, especially gastrointestinal malformations (aOR, 14.0; 95% CI, 2.9-66.7) were associated with Staphylococcus aureus sepsis. However, methicillin-resistant Staphylococcus aureus infection was not a risk factor for sepsis. The nomogram had high predictive accuracy for the estimation of sepsis risk, with an AUC of 0.85.ConclusionsWe developed a predictive model for sepsis in children with Staphylococcus aureus infection.
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