The management and outcomes of <i>Staphylococcus aureus</i> bacteraemia at a South African referral hospital: a prospective observational study. Steinhaus, N., Al-talib, M., Ive, P., Boyles, T., Bamford, C., Davies, M., Mendelson, M., & Wasserman, S. International Journal of Infectious Diseases, 73:78–84, 2018.
The management and outcomes of <i>Staphylococcus aureus</i> bacteraemia at a South African referral hospital: a prospective observational study [link]Paper  doi  abstract   bibtex   
Objectives: Data on the management and outcomes of Staphylococcus aureus bacteraemia (SAB) in resource-limited settings are limited. The aim of this study was to describe a cohort of South African patients with SAB, and explore the factors associated with complicated infection and death. Methods: This was a prospective observational study of patients over the age of 13 years admitted to a South African referral hospital with SAB. Results: One hundred SAB infection episodes occurring in 98 patients were included. SAB was healthcare-associated in 68.4%; 24.0% of all cases were caused by methicillin-resistant S. aureus (MRSA). Ninety-day mortality was 47.0%, with 83.3% of deaths attributable to SAB. There was a trend towards increased 90-day mortality with MRSA infection (odds ratio (OR) 1.28, 95% confidence interval (CI) 1.0-15.1) and the presence of comorbidities (OR 4.1, 95% CI 1.0-21.6). The risk of complicated infection was higher with non-optimal definitive antibiotic therapy (OR 8.5, 95% CI 1.8-52.4), female sex (OR 3.8, 95% CI 1.1-16.3), and community-acquired infection (OR 7.4, 95% CI 2.0-33.1). Definitive antibiotic therapy was non-optimal in 22.6% of all cases. Conclusions: SAB-related mortality was high. A large proportion of cases may be preventable, and there is a need for improved antibiotic management.
@article{Steinhaus2018,
abstract = {Objectives: Data on the management and outcomes of Staphylococcus aureus bacteraemia (SAB) in resource-limited settings are limited. The aim of this study was to describe a cohort of South African patients with SAB, and explore the factors associated with complicated infection and death. Methods: This was a prospective observational study of patients over the age of 13 years admitted to a South African referral hospital with SAB. Results: One hundred SAB infection episodes occurring in 98 patients were included. SAB was healthcare-associated in 68.4{\%}; 24.0{\%} of all cases were caused by methicillin-resistant S. aureus (MRSA). Ninety-day mortality was 47.0{\%}, with 83.3{\%} of deaths attributable to SAB. There was a trend towards increased 90-day mortality with MRSA infection (odds ratio (OR) 1.28, 95{\%} confidence interval (CI) 1.0-15.1) and the presence of comorbidities (OR 4.1, 95{\%} CI 1.0-21.6). The risk of complicated infection was higher with non-optimal definitive antibiotic therapy (OR 8.5, 95{\%} CI 1.8-52.4), female sex (OR 3.8, 95{\%} CI 1.1-16.3), and community-acquired infection (OR 7.4, 95{\%} CI 2.0-33.1). Definitive antibiotic therapy was non-optimal in 22.6{\%} of all cases. Conclusions: SAB-related mortality was high. A large proportion of cases may be preventable, and there is a need for improved antibiotic management.},
author = {Steinhaus, Nicola and Al-talib, Mohammed and Ive, Prudence and Boyles, Tom and Bamford, Colleen and Davies, Mary-Ann and Mendelson, Marc and Wasserman, Sean},
doi = {10.1016/j.ijid.2018.06.004},
file = {:C$\backslash$:/Users/Claire/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Steinhaus et al. - 2018 - The management and outcomes of Staphylococcus aureus bacteraemia at a South African referral hospital a prospe.pdf:pdf},
journal = {International Journal of Infectious Diseases},
keywords = {OA,fund{\_}ack,original},
mendeley-tags = {OA,fund{\_}ack,original},
pages = {78--84},
title = {{The management and outcomes of \textit{Staphylococcus aureus} bacteraemia at a South African referral hospital: a prospective observational study}},
url = {https://doi.org/10.1016/j.ijid.2018.06.004},
volume = {73},
year = {2018}
}

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