TY - JOUR
T1 - Coagulase-negative staphylococcal bacteremia
T2 - risk factors for mortality and impact of initial appropriate antimicrobial therapy on outcome
AU - Park, S. Y.
AU - Kwon, K. H.
AU - Chung, J. W.
AU - Huh, H. J.
AU - Chae, S. L.
N1 - Publisher Copyright:
© 2015, Springer-Verlag Berlin Heidelberg.
PY - 2015/7/23
Y1 - 2015/7/23
N2 - It is uncertain whether an initial inappropriate empirical antibiotic treatment of coagulase-negative staphylococci (CoNS) bacteremia adversely affects the outcome. A retrospective cohort study of CoNS bacteremia was performed at the Dongguk University Ilsan Hospital during a 3-year period. During the study period, 109 patients with CoNS bacteremia were enrolled. The median age of the patients was 72 years and most (96 %, 105/109) had one or more comorbid diseases. Among the participants, 29 % (32/109) received an appropriate empirical antimicrobial therapy. The 30-day mortality was 24 % (26/109) and CoNS bacteremia-related mortality was 14 % (15/109). There was no difference in the CoNS bacteremia-related mortality between the group with an inappropriate empirical treatment (13 %, 10/77) and that with an appropriate treatment (16 %, 5/32) (p = 0.46). In the multivariate analysis using the Cox regression analysis method, Pitt bacteremia scores [hazard ratio (HR) 1.48; 95 % confidence interval (CI) 1.09–2.01; p = 0.01] and retention of eradicable focus (HR 5.0; 95 % CI 1.39–17.9; p = 0.01) were found to be associated with CoNS bacteremia-related mortality. The results suggest that inappropriate empirical therapy might not necessarily be associated with the 30-day mortality or CoNS bacteremia-related mortality. Conversely, Pitt bacteremia scores and retention of eradicable focus were associated with poor outcomes.
AB - It is uncertain whether an initial inappropriate empirical antibiotic treatment of coagulase-negative staphylococci (CoNS) bacteremia adversely affects the outcome. A retrospective cohort study of CoNS bacteremia was performed at the Dongguk University Ilsan Hospital during a 3-year period. During the study period, 109 patients with CoNS bacteremia were enrolled. The median age of the patients was 72 years and most (96 %, 105/109) had one or more comorbid diseases. Among the participants, 29 % (32/109) received an appropriate empirical antimicrobial therapy. The 30-day mortality was 24 % (26/109) and CoNS bacteremia-related mortality was 14 % (15/109). There was no difference in the CoNS bacteremia-related mortality between the group with an inappropriate empirical treatment (13 %, 10/77) and that with an appropriate treatment (16 %, 5/32) (p = 0.46). In the multivariate analysis using the Cox regression analysis method, Pitt bacteremia scores [hazard ratio (HR) 1.48; 95 % confidence interval (CI) 1.09–2.01; p = 0.01] and retention of eradicable focus (HR 5.0; 95 % CI 1.39–17.9; p = 0.01) were found to be associated with CoNS bacteremia-related mortality. The results suggest that inappropriate empirical therapy might not necessarily be associated with the 30-day mortality or CoNS bacteremia-related mortality. Conversely, Pitt bacteremia scores and retention of eradicable focus were associated with poor outcomes.
UR - http://www.scopus.com/inward/record.url?scp=84931560934&partnerID=8YFLogxK
U2 - 10.1007/s10096-015-2364-3
DO - 10.1007/s10096-015-2364-3
M3 - Article
C2 - 25828065
AN - SCOPUS:84931560934
SN - 0934-9723
VL - 34
SP - 1395
EP - 1401
JO - European Journal of Clinical Microbiology and Infectious Diseases
JF - European Journal of Clinical Microbiology and Infectious Diseases
IS - 7
ER -