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Cited by 12Antimicrobial Resistance in StaphylococcusSepsis Diagnosis and TreatmentAntibiotic Use and Resistance

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The management and outcomes of Staphylococcus aureus bacteraemia at a South African referral hospital: A prospective observational study

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Steinhaus, Nicola, Al-talib, Mohammed, Ive, Prudence, Boyles, Tom, Bamford, Colleen, Davies, Mary-Ann, Mendelson, Marc, Wasserman, Sean·2018·International Journal of Infectious Diseases
DOI 10.1016/j.ijid.2018.06.004
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Abstract

OBJECTIVES: Data on the management and outcomes of Staphylococcus aureus bacteraemia (SAB) in resource-limited settings are limited. The aim of this study was to describe a cohort of South African patients with SAB, and explore the factors associated with complicated infection and death. METHODS: This was a prospective observational study of patients over the age of 13 years admitted to a South African referral hospital with SAB. RESULTS: One hundred SAB infection episodes occurring in 98 patients were included. SAB was healthcare-associated in 68.4%; 24.0% of all cases were caused by methicillin-resistant S. aureus (MRSA). Ninety-day mortality was 47.0%, with 83.3% of deaths attributable to SAB. There was a trend towards increased 90-day mortality with MRSA infection (odds ratio (OR) 1.28, 95% confidence interval (CI) 1.0-15.1) and the presence of comorbidities (OR 4.1, 95% CI 1.0-21.6). The risk of complicated infection was higher with non-optimal definitive antibiotic therapy (OR 8.5, 95% CI 1.8-52.4), female sex (OR 3.8, 95% CI 1.1-16.3), and community-acquired infection (OR 7.4, 95% CI 2.0-33.1). Definitive antibiotic therapy was non-optimal in 22.6% of all cases. CONCLUSIONS: SAB-related mortality was high. A large proportion of cases may be preventable, and there is a need for improved antibiotic management.

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  • The most common risk factors associated with MRSA infection are HIV infection, prior antibiotic use, ICU admission, prior or prolonged hospitalization, indwelling catheters, invasive procedures, open wounds and burns, residency at long-term care facilities, mechanical ventilation, renal failure, and MRSA colonization history.

    “The most common risk factors associated with MRSA infection are HIV infection, prior antibiotic use, ICU admission, prior or prolonged hospitalization, indwelling catheters, invasive procedures, open wounds and burns, residency at long-term care facilities, mechanical ventilation, renal failure, and MRSA colonization history.165,166”

    From Antimicrobial Resistance Rates and Surveillance in Sub-Saharan Africa: Where Are We Now? (2022) · cites this paper as [166]

    The Patient and infection characteristics section reports that most MRSA cases were healthcare-associated, but explicitly states that there were no significant univariate predictors of MRSA infection. It does not identify the listed conditions and exposures as the most common MRSA risk factors in this cohort. Page numbers were not available in our copy. (LLM, conf=0.84)

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Metadata

Authors
Steinhaus, N., Al-talib, M., Ive, P., Boyles, T., Bamford, C., Davies, M.-A., Mendelson, M., & Wasserman, S.
Affiliations
  • University of Cape Town (ZA)
  • National Health Laboratory Service (ZA)
Corresponding author
Steinhaus, Nicola
ORCID
Venue
International Journal of Infectious Diseases
Publisher
Elsevier BV
Published
2018-08
Volume
73
Pages
78-84
ISSN
1201-9712 (ISSN-L)
DOI
10.1016/j.ijid.2018.06.004
OpenAlex
W2808045882
Cited by
12
References
0
Citations by year
2026: 3 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 1
FWCI
0.19
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Infectious Diseases (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Open University of Cape Town (University of Cape Town) (submittedVersion)
Funders
Wellcome Trust (203135/Z/16/Z)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
  • Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
Keywords
Staphylococcus aureus bacteremia, methicillin-resistant Staphylococcus aureus, nosocomial infections, community-acquired infections, 90-day mortality, complicated infections, comorbidities, antibiotic therapy, resource-limited settings, South Africa
MeSH terms
Adult, Aged, Anti-Bacterial Agents, Female, Humans, Male, Middle Aged, Prospective Studies, Referral and Consultation, South Africa, Staphylococcal Infections, Bacteremia

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