Staphylococcus aureus bacteremia in a tertiary care hospital in India

Abstract

Abstract Background Staphylococcus aureus bacteremia (SAB) carries significant mortality and is increasingly caused by methicillin resistant Staphylococcus aureus (MRSA). Materials and methods We conducted a prospective observational study of 70 patients with SAB, between April 2014 and March 2015. Clinical and laboratory parameters of patients with MSSA and MRSA bacteremia were compared. Factors associated with poor outcome were analyzed. Results 70 patients (51 MSSA, 19 MRSA) with SAB constituted 7.56% of all bacteremias. Diabetes mellitus, chronic kidney disease, immunosuppressant usage and congestive heart failure were the most common co-morbid conditions. 5.71% of patients had infective endocarditis. Cefazolin and vancomycin were the commonest agents used for definitive therapy of MSSA and MRSA SAB respectively. There was no difference in co-morbidities, persistent bacteremia (pBact) or inappropriate antibiotic therapy between patients with MSSA and MRSA bacteremia. Severe sepsis and pBact were associated with a poor outcome. Conclusion SAB is a serious infection that carries a mortality of almost 25%, especially if patients present with severe sepsis or pBact. MSSA and MRSA bacteremia had similar features and outcome. Transesophageal echocardiography, detection and drainage of abscesses and appropriate parenteral antibiotics for a minimum of two weeks are recommended to avoid pBact and ensure a favorable outcome.