+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Preventing Staphylococcus aureus bacteremia and sepsis in patients with Staphylococcus aureus colonization of intravascular catheters: a retrospective multicenter study and meta-analysis



Preventing Staphylococcus aureus bacteremia and sepsis in patients with Staphylococcus aureus colonization of intravascular catheters: a retrospective multicenter study and meta-analysis



Medicine 90(4): 284-288



Two previous studies in tertiary care hospitals identified Staphylococcus aureus colonization of intravascular (IV) catheters as a strong predictor of subsequent S. aureus bacteremia (SAB), even in the absence of clinical signs of systemic infection. Bacteremia was effectively prevented by timely antibiotic therapy. We conducted this study to corroborate the validity of these findings in non-university hospitals.Using the laboratory information management systems of the clinical microbiology departments in 6 Dutch hospitals, we identified patients who had IV catheters from which S. aureus was cultured between January 1, 2003, and December 31, 2008. Patients with demonstrated SAB between 7 days before catheter removal and 24 hours after catheter removal were excluded. We extracted clinical and demographic patient data from the patients' medical records. The primary risk factor was initiation of anti-staphylococcal antibiotic therapy within 24 hours, and the primary endpoint was SAB >24 hours after IV catheter removal. Subsequently, we performed a systematic review and meta-analysis of all observational studies evaluating the effect of antibiotic therapy for S. aureus IV catheter tip colonization.In the current study, 18 of the 192 included patients developed subsequent SAB, which was associated with not receiving antibiotic therapy within 24 hours (odds ratio [OR], 4.2; 95% confidence interval [CI], 1.1-15.6) and with documented exit-site infection (OR, 3.3; 95% CI, 1.2-9.3). When we combined these results with results of a previous study in a university hospital, a third risk factor was also associated with subsequent SAB, namely corticosteroid therapy (OR, 2.9; 95% CI, 1.3-6.3). We identified 3 other studies, in addition to the present study, in a systematic review. In the meta-analysis of these studies, antibiotic therapy yielded an absolute risk reduction of 13.6% for subsequent SAB. The number needed to treat to prevent 1 episode of SAB was 7.4.We conclude that early initiation of antibiotic therapy for IV catheters colonized with S. aureus prevents subsequent SAB.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 055164907

Download citation: RISBibTeXText

PMID: 21694650

DOI: 10.1097/md.0b013e31822403e9


Related references

Staphylococcus aureus bacteremia in the surgical patient: a prospective analysis of 73 postoperative patients who developed Staphylococcus aureus bacteremia at a tertiary care facility. Journal of the American College of Surgeons 190(1): 50-57, 2000

Prospective multicenter study of Staphylococcus aureus bacteremia - results from the "Invasive Staphylococcus aureus Infection Cohort" (INSTINCT) study FT Epidemiologie, Verlauf and Prognose der Staphylococcus-aureus-Bakteriamie - Erste Ergebnisse der INSTINCT-Kohorte. 2008

Staphylococcus aureus colonization before infection is not associated with mortality among S. aureus-infected patients: a meta-analysis. Infection Control and Hospital Epidemiology 33(8): 796-802, 2012

Staphylococcus aureus bacteremia in immunosuppressed patients: a multicenter, retrospective cohort study. European Journal of Clinical Microbiology and Infectious Diseases 36(7): 1231-1241, 2017

Bacteremia due to staphylococcus aureus in adults related to the use of catheters or intravascular devices. Revista Clinica Espanola 180(3): 147-150, 1987

Phase II, randomized, multicenter, double-blind, placebo-controlled trial of a polyclonal anti-Staphylococcus aureus capsular polysaccharide immune globulin in treatment of Staphylococcus aureus bacteremia. Antimicrobial Agents and ChemoTherapy 51(12): 4249-4254, 2007

Proportions of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus in patients with surgical site infections in mainland China: a systematic review and meta-analysis. Plos one 10(1): E0116079, 2015

Quantifying the relationship between Staphylococcus aureus bacteremia and S. aureus bacteriuria: a retrospective analysis in a tertiary care hospital. Clinical Infectious Diseases 44(11): 1457-1459, 2007

A 5-year Survey Reveals Increased Susceptibility to Glycopeptides for Methicillin-Resistant Staphylococcus aureus Isolates from Staphylococcus aureus Bacteremia Patients in a Chinese Burn Center. Frontiers in Microbiology 8: 2531, 2017

Does Staphylococcus aureus Bacteriuria Influence Outcome in Patients With Staphylococcus aureus Bacteremia?. Infectious Disease in Clinical Practice 24(3): 131-132, 2016

Molecular epidemiologic analysis of methicillin-resistant Staphylococcus aureus isolates from bacteremia and nasal colonization at 10 intensive care units: multicenter prospective study in Korea. Journal of Korean Medical Science 26(5): 604-611, 2011

Staphylococcus aureus bacteremia in patients with Hickman catheters. American Journal of Medicine 89(2): 137-141, 1990

Methicillin-resistant Staphylococcus aureus colonization and risk of subsequent infection in critically ill children: importance of preventing nosocomial methicillin-resistant Staphylococcus aureus transmission. Clinical Infectious Diseases 53(9): 853-859, 2011

Non-hospital environment contamination with Staphylococcus aureus and methicillin-resistant Staphylococcus aureus: proportion meta-analysis and features of antibiotic resistance and molecular genetics. Environmental Research 150: 528-540, 2016

Some properties of Staphylococcus aureus, possibly related to pathogenicity. 2. Invitro properties and origin of the infecting strains correlated to mortality in 190 patients with Staphylococcus aureus bacteremia. Acta Pathol Et Microbiol Scand 47(3): 327-335, 1959