Fatality of Staphylococcus aureus infections in a Greek university hospital: role of inappropriate empiric treatment, methicillin resistance, and toxin genes ’ presence

AbstractThe aim of the present study was to identify predictors of fatality among patients withS. aureus infections requiring hospitalization. Cases hospitalized withS. aureus infections at the University General Hospital of Patras, Greece, during a 4-year period (2013 –2016) were studied.mecA, lukS/lukF-PV (Panton-Valentine leukocidin, PVL),tst (toxic shock syndrome toxin),fnbA (fibronectin-binding protein A),eta, andetb (epidermolytic toxins) genes ’ carriage was detected by PCR in 149 selected patients. Among 464 patients, 346 were included (118 with missing data). Primary bacteremia predominated (44.2%), followed by lower respiratory tract infections (13.6%), deep seated infections (9.8%), osteoarticular (9.5%), and catheter-related bloods tream infections (6.1%). Methicillin-resistantS. aureus (MRSA) represented 33.8% of infections and were less likely to receive appropriate empiric treatment (79.5%versus 97.4%;P< 0.001). Thirty-day fatality was 14.5%. Multivariate analysis revealed that development of septic shock, Charlson Comorbidity Index, lower respiratory tract infection, bacteremia (primary or secondary), MRSA, and CRP was significantly associated with fatality. Appropriate empiric treatment was a predictor of good prognosis. Thirty-two out of 149S. aureus (21.5%) carriedlukS/lukF-PV genes, whereas, 14 (9.4%), 133 (78.7%), four (2.7%), and one (0.7%) carriedtst,fnbA,eta, andetb genes, respectively. No difference was found among toxin genes ’ presence and ...
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research