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Defining the breakpoint duration of Staphylococcus aureus bacteremia predictive of poor outcomes

Clinical Infectious Diseases Feb 09, 2020

Minejima E, Mai N, Bui N, et al. - Researchers aimed at assessing the risk of poor outcomes in relation to Staphylococcus aureus bacteremia (SAB) duration via performing a multicenter, prospective, observational study of 884 adult hospitalized patients with SAB (mean age: 57 years; 70% male). Based on bacteremia duration, the grouping of patients was done; 63% of the patients had short (1–2 days), 28% had intermediate (3–6 days), and 9% had prolonged bacteremia (≥ 7 days). The highest proportion of methicillin-resistant SAB was evident in the prolonged group. They observed a progressive worsening of metastatic complications, length of stay, and 30-day mortality with increasing bacteremia duration. Every continued day of bacteremia was linked with a relative risk of death of 1.16, with a significant rise in risk starting at 3 days as defined by receiver operating characteristic analysis. They recommend targeting bacterial clearance as soon as possible in the optimal management of SAB for reducing the incremental risk of mortality with each day of positive blood culture. Prolonged bacteremia and worse outcomes were observed in significant correlation with delay in source control but not with type of antistaphylococcal therapy.
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