Table 2. Clinical characteristics, management, and outcomes of 203 patients with non-persistent and persistent catheter-related S. aureus bacteremia after catheter removal and initiation of appropriate antimicrobial therapy.
| Variable | Non-persistentCRSAB(n = 160) | PersistentCRSAB(n = 43) | Univariate analysis | Multivariate analysis | ||
| P value | OR (95% CI) | P value | OR (95% CI) | |||
| Age, median (IQR) | 62 (49–70) | 64 (53–72) | 0.16 | |||
| Male sex | 101 (63) | 27 (63) | 0.97 | |||
| Community-onset of infection | 20 (13) | 7 (16) | 0.52 | |||
| Methicillin resistance | 84 (53) | 38 (88) | <0.001 | 6.88(2.57–18.37) | <0.001 | 9.01(3.05–26.61) |
| Comorbidity | ||||||
| Underlying malignancy | 86 (54) | 22 (51) | 0.76 | |||
| Renal failure | 35 (22) | 21 (49) | <0.001 | 3.41(1.68–6.90) | 0.003 | 3.23(1.48–7.08) |
| Diabetes mellitus | 46 (29) | 10 (23) | 0.47 | |||
| Liver cirrhosis | 29 (18) | 5 (12) | 0.31 | |||
| Type of catheter | ||||||
| Central venous catheter | 120 (75) | 40 (93) | 0.01 | 4.44(1.30–15.15) | ||
| Long-term intravascular catheters1 | 31 (19) | 11 (26) | 0.37 | |||
| External signs of catheter infection | 32 (20) | 8 (19) | 0.84 | |||
| Presence of non-catheter prosthetic devices2 | 8 (5) | 9 (21) | 0.003 | 5.03(1.81–13.98) | 0.006 | 5.37(1.62–17.80) |
| APACHE II score, median (IQR) | 17 (12–21) | 19 (13–23) | 0.13 | |||
| Pitt bacteremia score, median (IQR) | 1 (0–3) | 1 (0–3) | 0.76 | |||
| Intensive care unit stay | 44 (28) | 15 (35) | 0.34 | |||
| Mechanical ventilation | 29 (18) | 7 (16) | 0.78 | |||
| Prescription of immunosuppressive therapy3 | 36 (23) | 7 (16) | 0.38 | |||
| Prescription of cancer chemotherapy3 | 28 (18) | 5 (12) | 0.35 | |||
| Recent surgery3 | 45 (28) | 12 (28) | 0.98 | |||
| Clinical management | ||||||
| Catheter removal within 48 hrs | 120 (75) | 38 (88) | 0.06 | |||
| Initiation of appropriate antibiotics within 48 hrs | 141 (88) | 37 (86) | 0.71 | |||
| Initial vancomycin use (to MSSA isolates) | 31/76 (41) | 5/5 (100) | 0.02 | |||
| Duration of antibiotic therapy | 15 (11–21) | 27 (20–47) | <0.001 | |||
| Outcome | ||||||
| Complicated S. aureus bacteremia | 24 (15) | 31 (72) | <0.001 | |||
| Complicated infection | 7 (4) | 27 (63) | <0.001 | |||
| Septic thrombophlebitis | 6 (4) | 13 (30) | <0.001 | |||
| Infective endocarditis | 0 (0) | 6 (14) | <0.001 | |||
| Other metastatic seeding of infection4 | 1 (1) | 15 (35) | <0.001 | |||
| Attributable mortality | 13 (8) | 10 (23) | 0.01 | |||
| Late complication | 4 (3) | 2 (5) | 0.61 | |||
| No complications due to S. aureus bacteremia | 136 (85) | 12 (28) | <0.001 | |||
| Uncomplicated S. aureus bacteremia | 113 (71) | 10 (23) | <0.001 | |||
| Death not-related S. aureus bacteremia | 23 (14) | 2 (5) | 0.09 | |||
NOTE: Data are no. (%) of patients, unless otherwise indicated. CRSAB, catheter-related Staphylococcus aureus bacteremia; OR, odds ratio; CI, confidence interval; IQR, interquartile range; MSSA, methicillin-susceptible S. aureus; APACHE II, Acute Physiology and Chronic Health Evaluation II.
1
Includes perm catheter (n = 30), Hickman catheter (n = 10), and subcutaneous port catheters (n = 2).
2
Includes prosthetic valve (n = 7), synthetic vascular graft (n = 5), and orthopedic device (n = 5).
3
Within previous one month.
4
Includes septic emboli to lungs (n = 8), deep tissue abscess (n = 6), septic arthritis (n = 1), and osteomyelitis (n = 1).