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Risk factors for recurrence after Staphylococcus aureus bacteraemia. A retrospective matched case–control study

2009; Elsevier BV; Volume: 58; Issue: 6 Linguagem: Inglês

10.1016/j.jinf.2009.03.011

1532-2742

Timothy M. Walker, I.C.J.W. Bowler, Philip Bejon,

Bacterial Identification and Susceptibility Testing

Objectives We sought to identify risk factors for recurrence of Staphylococcus aureus bacteraemia (SAB) by auditing compliance with guidelines on its treatment in our hospital. Methods We retrospectively identified patients over the preceding 8 years whose SAB had recurred, matching each to a control patient with non-recurrent SAB. Results 40/1870 patients with SAB had suffered recurrent disease (2.1%), 33 of whom were available for study. Where 2, 4 and 6 weeks of intravenous therapy were recommended, 78%, 29% and 25% of patients received it, and there was no association with recurrence. Glycopeptide use in patients with methicillin sensitive SAB (MSSA) was significantly associated with recurrence (p=0.015). Where the source of the bacteraemia was a peripheral venous catheter the odds of recurrence were less than where an SAB originated at another site (p=0.047). All patients with SAB in whom a central venous catheter was not removed suffered recurrence. Conclusions We found the recurrence rate after SAB was low despite poor compliance with guidelines on treatment duration. Glycopeptide therapy for MSSA bacteraemia was more likely to result in recurrent SAB than β-lactam therapy. Recurrence was significantly less likely in patients where the source of the SAB was a peripheral line than in those with another source.