Medicine (Austin & Northern Health) - Research Publications

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Author: Athan, Eugene × Start date: 2000 ×

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    Risk Factors forMycobacterium ulceransInfection, Southeastern Australia
    Quek, TYJ ; Athan, E ; Henry, MJ ; Pasco, JA ; Redden-Hoare, J ; Hughes, A ; Johnson, PDR (Centers for Disease Control and Prevention (CDC), 2007-11)
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    Morbidity from in-hospital complications is greater than treatment failure in patients with Staphylococcus aureus bacteraemia
    Holmes, NE ; Robinson, JO ; van Hal, SJ ; Munckhof, WJ ; Athan, E ; Korman, TM ; Cheng, AC ; Turnidge, JD ; Johnson, PDR ; Howden, BP (BMC, 2018-03-05)
    BACKGROUND: Various studies have identified numerous factors associated with poor clinical outcomes in patients with Staphylococcus aureus bacteraemia (SAB). A new study was created to provide deeper insight into in-hospital complications and risk factors for treatment failure. METHODS: Adult patients hospitalised with Staphylococcus aureus bacteraemia (SAB) were recruited prospectively into a multi-centre cohort. The primary outcome was treatment failure at 30 days (composite of all-cause mortality, persistent bacteraemia, or recurrent bacteraemia), and secondary measures included in-hospital complications and mortality at 6- and 12-months. Data were available for 222 patients recruited from February 2011 to December 2012. RESULTS: Treatment failure at 30-days was recorded in 14.4% of patients (30-day mortality 9.5%). Multivariable analysis predictors of treatment failure included age > 70 years, Pitt bacteraemia score ≥ 2, CRP at onset of SAB > 250 mg/L, and persistent fevers after SAB onset; serum albumin at onset of SAB, receipt of appropriate empiric treatment, recent healthcare attendance, and performing echocardiography were protective. 6-month and 12-month mortality were 19.1% and 24.2% respectively. 45% experienced at least one in-hospital complication, including nephrotoxicity in 19.5%. CONCLUSIONS: This study demonstrates significant improvements in 30-day outcomes in SAB in Australia. However, we have identified important areas to improve outcomes from SAB, particularly reducing renal dysfunction and in-hospital treatment-related complications.