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Clinical characteristics and outcomes of diabetic patients with Staphylococcus aureus bacteremia and endocarditis.

Publication ,  Journal Article
Kanafani, ZA; Kourany, WM; Fowler, VG; Levine, DP; Vigliani, GA; Campion, M; Katz, DE; Corey, GR; Boucher, HW
Published in: Eur J Clin Microbiol Infect Dis
December 2009

The complications from S. aureus bacteremia (SAB) and infective endocarditis (SAIE) are higher in patients with diabetes. We summarize the characteristics and outcome of diabetic patients enrolled in a multicenter trial of daptomycin vs. standard therapy for SAB and SAIE. Adult patients with SAB were randomized to daptomycin 6 mg/kg/day or standard therapy (vancomycin 1 g every 12 h or antistaphylococcal penicillin 2 g every 4 h, both with gentamicin 1 mg/kg every 8 h for 4 days). Clinical success was defined as survival, resolution of S. aureus infection, and clinical outcome of cure or improved 6 weeks after end of therapy. Diabetic patients (86/235) were older, more overweight, and were more likely to present with systemic inflammatory response syndrome (SIRS) and to have complicated SAB. Clinical success rates were similar (67.4% in diabetics and 70.5% in non-diabetics). The mortality rate was significantly higher among diabetic patients (22.1% vs. 11.4%, p = 0.038). In the diabetes subgroup, the clinical success and mortality rates were comparable between the daptomycin and the standard therapy arms. The presence of diabetes is associated with significantly higher mortality in patients with SAB and SAIE. Daptomycin is an alternative therapeutic option in diabetic patients with these serious staphylococcal infections.

Duke Scholars

Published In

Eur J Clin Microbiol Infect Dis

DOI

EISSN

1435-4373

Publication Date

December 2009

Volume

28

Issue

12

Start / End Page

1477 / 1482

Location

Germany

Related Subject Headings

  • Vancomycin
  • Treatment Outcome
  • Systemic Inflammatory Response Syndrome
  • Survival Analysis
  • Staphylococcus aureus
  • Staphylococcal Infections
  • Prevalence
  • Penicillins
  • Middle Aged
  • Microbiology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kanafani, Z. A., Kourany, W. M., Fowler, V. G., Levine, D. P., Vigliani, G. A., Campion, M., … Boucher, H. W. (2009). Clinical characteristics and outcomes of diabetic patients with Staphylococcus aureus bacteremia and endocarditis. Eur J Clin Microbiol Infect Dis, 28(12), 1477–1482. https://doi.org/10.1007/s10096-009-0808-3
Kanafani, Z. A., W. M. Kourany, V. G. Fowler, D. P. Levine, G. A. Vigliani, M. Campion, D. E. Katz, G. R. Corey, and H. W. Boucher. “Clinical characteristics and outcomes of diabetic patients with Staphylococcus aureus bacteremia and endocarditis.Eur J Clin Microbiol Infect Dis 28, no. 12 (December 2009): 1477–82. https://doi.org/10.1007/s10096-009-0808-3.
Kanafani ZA, Kourany WM, Fowler VG, Levine DP, Vigliani GA, Campion M, et al. Clinical characteristics and outcomes of diabetic patients with Staphylococcus aureus bacteremia and endocarditis. Eur J Clin Microbiol Infect Dis. 2009 Dec;28(12):1477–82.
Kanafani, Z. A., et al. “Clinical characteristics and outcomes of diabetic patients with Staphylococcus aureus bacteremia and endocarditis.Eur J Clin Microbiol Infect Dis, vol. 28, no. 12, Dec. 2009, pp. 1477–82. Pubmed, doi:10.1007/s10096-009-0808-3.
Kanafani ZA, Kourany WM, Fowler VG, Levine DP, Vigliani GA, Campion M, Katz DE, Corey GR, Boucher HW. Clinical characteristics and outcomes of diabetic patients with Staphylococcus aureus bacteremia and endocarditis. Eur J Clin Microbiol Infect Dis. 2009 Dec;28(12):1477–1482.
Journal cover image

Published In

Eur J Clin Microbiol Infect Dis

DOI

EISSN

1435-4373

Publication Date

December 2009

Volume

28

Issue

12

Start / End Page

1477 / 1482

Location

Germany

Related Subject Headings

  • Vancomycin
  • Treatment Outcome
  • Systemic Inflammatory Response Syndrome
  • Survival Analysis
  • Staphylococcus aureus
  • Staphylococcal Infections
  • Prevalence
  • Penicillins
  • Middle Aged
  • Microbiology