scholarly journals Clinical Practice Variation in the Management of Staphylococcus aureus Bacteremia: Results from an Emerging Infections Network Survey

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S553-S553 ◽  
Author(s):  
Luke Strnad ◽  
Susan E Beekmann ◽  
Philip M Polgreen ◽  
Henry Chambers ◽  
Catherine Liu
Keyword(s):  
Staphylococcus Aureus ◽  
Clinical Practice ◽  
Practice Variation ◽  
Emerging Infections ◽  
Staphylococcus Aureus Bacteremia

scholarly journals Clinical Practice Variation Among Adult Infectious Disease Physicians in the Management of Staphylococcus aureus Bacteremia

2019 ◽  
Vol 69 (3) ◽  
pp. 530-533 ◽  
Author(s):  
Catherine Liu ◽  
Luke Strnad ◽  
Susan E Beekmann ◽  
Philip M Polgreen ◽  
Henry F Chambers
Keyword(s):  
Infectious Disease ◽  
Staphylococcus Aureus ◽  
Clinical Practice ◽  
Disease Management ◽  
Best Practices ◽  
Practice Variation ◽  
Adult Patients ◽  
Diagnostic Evaluation ◽  
Emerging Infections ◽  
Staphylococcus Aureus Bacteremia

Abstract Infectious disease management of Staphylococcus aureus bacteremia (SAB) was surveyed through the Emerging Infections Network. Although there were areas of consensus, we found substantial practice variation in diagnostic evaluation and management of adult patients with SAB. These findings highlight opportunities for further research and guidance to define best practices.

scholarly journals Interventions to treat methicillin-susceptible Staphylococcus aureus bacteremia: many methodological concerns

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Herney Andrés García-Perdomo ◽  
Jessica Fernanda Toro Maldonado
Keyword(s):  
Staphylococcus Aureus ◽  
Clinical Practice ◽  
Staphylococcus Aureus Bacteremia ◽  
Information Bias ◽  
Increasing Trend

Abstract The aim of this letter was to point out some methodological concerns about an article written by Shi et al. and published in the journal. There is an increasing trend in the isolation of Methicillin-susceptible Staphylococcus aureus bacteremia and a variety of questions regarding the best therapy to treat this condition. These concerns might lead to selection, publication and information bias that prevent the generalization and application of these results in our clinical practice.

scholarly journals 1059. Staphylococcus aureus Bacteremia Treatment: Results From Pilot Surveillance in Four US States

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S316-S317
Author(s):  
Sarah Kabbani ◽  
Kelly Jackson ◽  
Lauren Epstein ◽  
Anita Gellert ◽  
Carmen Bernu ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Management Practices ◽  
Treatment Guidelines ◽  
Descriptive Analysis ◽  
Quality Measures ◽  
Population Based ◽  
Emerging Infections ◽  
Staphylococcus Aureus Bacteremia ◽  
Duration Of Hospitalization ◽  
Initial Culture

Abstract Background Staphylococcus aureus treatment guidelines are being revised to include proposed quality measures for evaluation of patients with S. aureus bacteremia (SAB) (e.g., infectious disease [ID] consultation, echocardiogram, and documenting clearance of bacteremia). We describe current management practices of SAB to identify opportunities for quality improvement. Methods We conducted a pilot assessment of SAB cases reported to CDC’s Emerging Infections Program active, laboratory- and population-based surveillance from 24 hospitals in four states during 1–2 months in 2017 or 2018. An SAB case was the isolation of S. aureus from a blood culture among adults (≥18 years) in the catchment area. We collected clinical and demographic information and performed a descriptive analysis of management of SAB cases. Results Among 109 SAB cases identified, 50 (46%) were methicillin-resistant S. aureus (MRSA). While hospitalized, 87 (80%) patients were evaluated by ID consultation, 90 (83%) underwent an echocardiogram (26 were transesophageal), and 92 (84%) had documented clearance of bacteremia. During the hospitalization, 15 (14%) died and 12 (11%) left against medical advice (AMA). Of those who survived and did not leave AMA, median duration of hospitalization after initial culture was 10.5 days (interquartile range 7–18). In total, 10 survivors (9% of cases) completed at least 2 weeks of antibiotics while hospitalized, and 65 (60% of cases) were discharged on antibiotic therapy. Among the 25 MRSA patients discharged on antibiotics, common treatments were vancomycin (64%), daptomycin (8%), ceftaroline (8%), and linezolid (4%). Among the 40 methicillin-susceptible SAB patients discharged on antibiotics, cefazolin (56%), ceftriaxone (13%), cefepime (5%), linezolid (5%), nafcillin (3%), and vancomycin (3%) were most common. The remainder of outpatient treatments included oral β-lactams, clindamycin, doxycycline, levofloxacin, and erythromycin. Conclusion Overall, the majority of patients with SAB underwent evaluation according to the proposed quality measures and received therapy with targeted anti-staphylococcal agents, although opportunities to optimize treatment remain. Hospitalized patients who leave AMA represent a particular challenge for effective SAB therapy. Disclosures All authors: No reported disclosures.

Comparable Outcomes of Short-Course and Prolonged-Course Therapy in Selected Cases of Methicillin-Susceptible Staphylococcus aureus Bacteremia: A Pooled Cohort Study

2021 ◽  
Author(s):  
Louise Thorlacius-Ussing ◽  
Håkon Sandholdt ◽  
Jette Nissen ◽  
Jon Rasmussen ◽  
Robert Skov ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Clinical Outcomes ◽  
Treatment Duration ◽  
Cohort Analysis ◽  
Antimicrobial Treatment ◽  
Low Risk ◽  
Logistic Regression Models ◽  
Staphylococcus Aureus Bacteremia ◽  
Short Course ◽  
The Individual

Abstract Background The recommended duration of antimicrobial treatment for Staphylococcus aureus bacteremia (SAB) is a minimum of 14 days. We compared the clinical outcomes of patients receiving short-course (SC; 6–10 days), or prolonged-course (PC; 11–16 days) antibiotic therapy for low-risk methicillin-susceptible SAB (MS-SAB). Methods Adults with MS-SAB in 1995–2018 were included from 3 independent retrospective cohorts. Logistic regression models fitted with inverse probability of treatment weighting were used to assess the association between the primary outcome of 90-day mortality and treatment duration for the individual cohorts as well as a pooled cohort analysis. Results A total of 645, 219, and 141 patients with low-risk MS-SAB were included from cohorts I, II, and III. Median treatment duration in the 3 SC groups was 8 days (interquartile range [IQR], 7–10), 9 days (IQR, 8–10), and 8 days (IQR, 7–10). In the PC groups, patients received a median therapy of 14 days (IQR, 13–15), 14 days (IQR, 13–15), and 13 days (IQR, 12–15). No significant differences in 90-day mortality were observed between the SC and PC group in cohort I (odds ratio [OR], 0.85 [95% confidence interval {CI}, .49–1.41]), cohort II (OR, 1.24 [95% CI, .60–2.62]), or cohort III (OR, 1.15 [95% CI, .24–4.01]). This result was consistent in the pooled cohort analysis (OR, 1.05 [95% CI, .71–1.51]). Furthermore, duration of therapy was not associated with the risk of relapse. Conclusions In patients with low-risk MS-SAB, shorter courses of antimicrobial therapy yielded similar clinical outcomes as longer courses of therapy.

Lack of correlation of virulence gene profiles of Staphylococcus aureus bacteremia isolates with mortality

2019 ◽  
Vol 133 ◽  
pp. 103543 ◽  
Author(s):  
Kyung-Hwa Park ◽  
Kerryl E. Greenwood-Quaintance ◽  
Scott A. Cunningham ◽  
Govindarajan Rajagopalan ◽  
Nicholas Chia ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Virulence Gene ◽  
Staphylococcus Aureus Bacteremia ◽  
Gene Profiles

scholarly journals Characteristics Associated With Invasive Staphylococcus aureus Infection Rates in Nursing Homes, Emerging Infections Program

2020 ◽  
Vol 41 (S1) ◽  
pp. s60-s61
Author(s):  
Runa Gokhale ◽  
Kelly Jackson ◽  
Kelly Hatfield ◽  
Susan Petit ◽  
Susan Ray ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Nursing Homes ◽  
Influenza Vaccination ◽  
Incidence Rates ◽  
Resistant Organism ◽  
Short Stay ◽  
Emerging Infections ◽  
Infection Rates ◽  
Targeted Interventions ◽  
Surveillance Area

Background: Most invasive methicillin-resistant Staphylococcus aureus (iMRSA) infections have onset in the community but are associated with healthcare exposures. More than 25% of cases with healthcare exposure occur in nursing homes (NHs) where facility-specific iMRSA rates vary widely. We assessed associations between nursing home characteristics and iMRSA incidence rates to help target prevention efforts in NHs. Methods: We used active, laboratory- and population-based surveillance data collected through the Emerging Infections Program during 2011–2015 from 25 counties in 7 states. NH-onset cases were defined as isolation of MRSA from a normally sterile site in a surveillance area resident who was in a NH within 3 days before the index culture. We calculated MRSA incidence (cases per NH resident day) using Centers for Medicare & Medicaid Services (CMS) skilled nursing facility cost reports and described variation in iMRSA incidence by NH. We used Poisson regression with backward selection, assessing variables for collinearity, to estimate adjusted rate ratios (aRRs) for NH characteristics (obtained from the CMS minimum dataset) associated with iMRSA rates. Results: Of 590 surveillance area NHs included in analysis, 89 (15%) had no NH-onset iMRSA infections. Rates ranged from 0 to 23.4 infections per 100,000 resident days. Increased rate of NH-onset iMRSA infection occurred with increased percentage of residents in short stay ≤30 days (aRR, 1.09), exhibiting wounds or infection (surgical wound [aRR, 1.08]; vascular ulcer/foot infection [aRR, 1.09]; multidrug-resistant organism infection [aRR, 1.13]; receipt of antibiotics [aRR, 1.06]), using medical devices or invasive support (ostomy [aRR, 1.07]; dialysis [aRR, 1.07]; ventilator support [aRR, 1.17]), carrying neurologic diagnoses (cerebral palsy [aRR, 1.14]; brain injury [aRR, 1.1]), and demonstrating debility (requiring considerable assistance with bed mobility [aRR, 1.05]) (Table). iMRSA rates decreased with increased percentage of residents receiving influenza vaccination (aRR, 0.96) and with the presence of any patients in isolation for any active infection (aRR, 0.83). Conclusions: iMRSA incidence varies greatly across nursing homes, with many NH patient and facility characteristics associated with NH-onset iMRSA rate differences. Some associations (short stay, wounds and infection, medical device use and invasive support) suggest that targeted interventions utilizing known strategies to decrease transmission may help to reduce infection rates, while others (neurologic diagnoses, influenza vaccination, presence of patients in isolation) require further exploration to determine their role. These findings can help identify NHs in other areas more likely to have higher rates of NH-onset iMRSA who could benefit from interventions to reduce infection rates.Funding: NoneDisclosures: None

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