TABLE 1.
Clinical characteristics of 93 patients treated with cefazolin or oxacillin for complicated MSSA bacteremia
| Characteristic | Valuea for patients treated with: |
P value | ||
|---|---|---|---|---|
| Overall (n = 93) | Oxacillin (n = 34) | Cefazolin (n = 59) | ||
| Mean age (yr) ± SD | 51 ± 12 | 51 ± 14 | 51 ± 10 | 0.75 |
| Male gender | 72 (77) | 28 (82) | 44 (75) | 0.45 |
| Mean wt (kg) ± SD | 81 ± 17 | 77 ± 18 | 83 ± 16 | 0.13 |
| Mean body mass index (kg/m2) ± SD | 29 ± 6 | 28 ± 7 | 30 ± 6 | 0.15 |
| History of intravenous drug use | 29 (31) | 10 (30) | 19 (32) | 0.60 |
| History of alcohol use | 50 (54) | 21 (62) | 29 (49) | 0.21 |
| Comorbidities | ||||
| Diabetes mellitus | 47 (51) | 16 (47) | 31 (53) | 0.67 |
| End-stage renal disease | 15 (16) | 0 (0) | 15 (25) | <0.001 |
| Cirrhosis | 19 (20) | 6 (18) | 13 (22) | 0.79 |
| Cancer | 6 (6) | 1 (3) | 5 (9) | 0.41 |
| Other immunosuppression | 6 (6) | 2 (6) | 4 (7) | 1.0 |
| Admission status | ||||
| Medical | 74 (80) | 23 (68) | 51 (86) | 0.04 |
| Surgical | 9 (10) | 5 (15) | 4 (7) | 0.28 |
| Intensive care unit | 10 (11) | 6 (18) | 4 (7) | 0.16 |
| Median Pitt bacteremia scoreb | 0 (0–1) | 0 (0–1) | 0 (0–1) | 0.88 |
| Mean white blood cell count (1,000/mm3) ± SD | 14 ± 7 | 15 ± 8 | 13 ± 7 | 0.28 |
| Mean serum creatinine (mg/dl) ± SD | 1.2 ± 0.7 | 1.1 ± 0.5 | 1.2 ± 0.9 | 0.80 |
| Presence of fever | 54 (58) | 18 (53) | 36 (61) | 0.52 |
| Presence of catheters | 12 (13) | 1 (3) | 11 (19) | 0.05 |
| Catheter removal | 11/12 (92) | 1/1 (100) | 10/11 (91) | 1.0 |
| Presence of other foreign material | 19 (20) | 3 (9) | 16 (27) | 0.06 |
| Foreign material removal | 6/19 (32) | 1/3 (33) | 5/16 (31) | 1.0 |
| Received surgical intervention | 44 (47) | 19 (56) | 25 (42) | 0.28 |
| Multiple surgical procedures | 18/44 (41) | 8/19 (42) | 10/25 (40) | 0.79 |
| Median time to surgery (days)b | 4 (2–6) | 3 (2–5) | 4 (2–7) | 0.13 |
| Metastatic spread of infection | 32 (34) | 12 (35) | 20 (34) | 0.82 |
| Multiple sites of metastasis | 9/32 (28) | 5/12 (41) | 4/20 (20) | 0.42 |
| Primary source | ||||
| Catheter | 7 (8) | 1 (3) | 6 (10) | 0.42 |
| Pneumonia | 4 (4) | 2 (6) | 2 (4) | 0.62 |
| Endovascularc | 19 (20) | 4 (12) | 15 (25) | 0.18 |
| Possible endocarditis | 4/17 (24) | 1/3 (33) | 3/14 (21) | |
| Right-sided endocarditis | 4/17 (24) | 1/3 (33) | 3/14 (21) | |
| Left-sided endocarditis | 7/17 (41) | 1/3 (33) | 6/14 (43) | |
| Right- and left-sided endocarditis | 2/17 (12) | 0/3 (0) | 2/14 (14) | |
| Osteoarticular | 38 (41) | 20 (59) | 18 (31) | 0.009 |
| Soft tissue | 9 (10) | 1 (3) | 8 (14) | 0.15 |
| Urinary tract | 6 (6) | 4 (12) | 2 (3) | 0.19 |
| Unknown | 10 (11) | 2 (6) | 8 (14) | 0.32 |
a
Values are numbers (with percentages in parentheses) unless indicated otherwise.
b
Values are medians (with interquartile ranges in parentheses).
c
Endocarditis was the primary source of infection in 17 of 19 patients. For one patient in each group, a septic thrombus was identified as the primary source. One patient in each group also had involvement of an intracardiac device. Two patients in the cefazolin arm had prosthetic valve endocarditis (one right-sided and one left-sided).