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Risk factors for hematogenous complications of intravascular catheter-associated Staphylococcus aureus bacteremia.

Publication ,  Journal Article
Fowler, VG; Justice, A; Moore, C; Benjamin, DK; Woods, CW; Campbell, S; Reller, LB; Corey, GR; Day, NPJ; Peacock, SJ
Published in: Clin Infect Dis
March 1, 2005

BACKGROUND: The role of both host and pathogen characteristics in hematogenous seeding following Staphylococcus aureus bacteremia is incompletely understood. METHODS: Consecutive patients with intravascular catheter-associated Staphylococcus aureus bacteremia were prospectively recruited over a 91-month period. The corresponding bloodstream isolates were examined for the presence of 35 putative virulence determinants. Patient and bacterial characteristics associated with the development of hematogenous complications (HCs) (i.e., septic arthritis, vertebral osteomyelitis, or endocarditis) were defined. RESULTS: HC occurred in 42 (13%) of 324 patients. Patient characteristics at diagnosis that were associated with HC included community onset (relative risk [RR], 2.25; 95% confidence interval [CI], 1.24-4.07; P=.007), increased symptom duration (odds ratio for each day, 1.14; 95% CI, 1.06-1.2; P<.001), presence of a long-term intravascular catheter or noncatheter prosthesis (RR, 4.02; 95% CI, 1.74-9.27; P<.001), hemodialysis dependence (RR, 3.84; 95% CI, 2.08-7.10; P<.001), and higher APACHE II score (P=.02). Bacterial characteristics included sea (RR, 2.03; 95% CI, 1.16-3.55; P=.011) and methicillin-resistant S. aureus (MRSA) (RR, 2.09; 95% CI, 1.19-3.67; P=.015). Subsequent failure to remove a catheter was also associated with HC (RR, 2.28; 95% CI, 1.22-4.27; P=.011). On multivariable analysis, symptom duration, hemodialysis dependence, presence of a long-term intravascular catheter or a noncatheter device, and infection with MRSA remained significantly associated with HC. CONCLUSIONS: This investigation identifies 4 host- and pathogen-related risk factors for hematogenous bacterial seeding and reaffirms the importance of prompt catheter removal.

Duke Scholars

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

March 1, 2005

Volume

40

Issue

5

Start / End Page

695 / 703

Location

United States

Related Subject Headings

  • Virulence Factors
  • Staphylococcus aureus
  • Staphylococcal Infections
  • Risk Factors
  • Multivariate Analysis
  • Middle Aged
  • Microbiology
  • Methicillin Resistance
  • Male
  • Humans
 

Citation

APA
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ICMJE
MLA
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Fowler, V. G., Justice, A., Moore, C., Benjamin, D. K., Woods, C. W., Campbell, S., … Peacock, S. J. (2005). Risk factors for hematogenous complications of intravascular catheter-associated Staphylococcus aureus bacteremia. Clin Infect Dis, 40(5), 695–703. https://doi.org/10.1086/427806
Fowler, Vance G., Anita Justice, Catrin Moore, Daniel K. Benjamin, Christopher W. Woods, Steven Campbell, L Barth Reller, G Ralph Corey, Nicholas P. J. Day, and Sharon J. Peacock. “Risk factors for hematogenous complications of intravascular catheter-associated Staphylococcus aureus bacteremia.Clin Infect Dis 40, no. 5 (March 1, 2005): 695–703. https://doi.org/10.1086/427806.
Fowler VG, Justice A, Moore C, Benjamin DK, Woods CW, Campbell S, et al. Risk factors for hematogenous complications of intravascular catheter-associated Staphylococcus aureus bacteremia. Clin Infect Dis. 2005 Mar 1;40(5):695–703.
Fowler, Vance G., et al. “Risk factors for hematogenous complications of intravascular catheter-associated Staphylococcus aureus bacteremia.Clin Infect Dis, vol. 40, no. 5, Mar. 2005, pp. 695–703. Pubmed, doi:10.1086/427806.
Fowler VG, Justice A, Moore C, Benjamin DK, Woods CW, Campbell S, Reller LB, Corey GR, Day NPJ, Peacock SJ. Risk factors for hematogenous complications of intravascular catheter-associated Staphylococcus aureus bacteremia. Clin Infect Dis. 2005 Mar 1;40(5):695–703.
Journal cover image

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

March 1, 2005

Volume

40

Issue

5

Start / End Page

695 / 703

Location

United States

Related Subject Headings

  • Virulence Factors
  • Staphylococcus aureus
  • Staphylococcal Infections
  • Risk Factors
  • Multivariate Analysis
  • Middle Aged
  • Microbiology
  • Methicillin Resistance
  • Male
  • Humans