Clinical significance and outcome of polymicrobial Staphylococcus aureus bacteremia

Seong Yeon Park, Ki Ho Park, Kyung Mi Bang, Yong Pil Chong, Sung Han Kim, Sang Oh Lee, Sang Ho Choi, Jin Young Jeong, Jun Hee Woo, Yang Soo Kim

Research output: Contribution to journalArticlepeer-review

32 Scopus citations

Abstract

Objectives: The clinical significance of polymicrobial Staphylococcus aureus bacteremia (SAB) remains unclear. We therefore compared the clinical features and outcomes of polymicrobial and monomicrobial SAB. Methods: A prospective cohort study of patients with SAB was performed during a 20-months. Polymicrobial SAB was defined as the simultaneous isolation of S. aureus and other microorganisms from blood cultures. However, Corynebacterium spp., Bacillus spp., and coagulase-negative staphylococci were considered contaminants unless they were related to device infection and grew in two or more blood cultures. Results: During the study period, 44 (10%) patients had polymicrobial and 412 (90%) had monomicrobial SAB. A total of 54 microorganisms were isolated from the former, with Enterococcus spp. (22%) being the most common. Independent risk factors for polymicrobial SAB included neutropenia (odds ratio [OR] 3.5, p = 0.02), biliary tract catheters (OR 5.0, p = 0.001), and intra-abdominal infection (OR 10.3, p < 0.001). Clinical outcomes were significantly worse among patients with polymicrobial than monomicrobial SAB, including bacteremia-related and 7-day mortality rates. Independent predictors of bacteremia-related mortality were solid tumors (HR 2.0, p = 0.03) and polymicrobial SAB (HR 2.8, p = 0.007). Conclusions: Polymicrobial SAB is associated with more severe illness than monomicrobial SAB, with neutropenia, biliary tract catheters and intra-abdominal infection being significant risk factors for polymicrobial SAB.

Original languageEnglish
Pages (from-to)119-127
Number of pages9
JournalJournal of Infection
Volume65
Issue number2
DOIs
StatePublished - Aug 2012

Keywords

  • Polymicrobial bacteremia
  • Staphylococcus aureus

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