Table 1.
Patient demographics, severity of illness, clinical management and outcome in 617 methicillin-sensitive Staphylococcus aureus bacteremia patients stratified according to break-point age of 60 years and presence of formal (bedside) infectious specialist consultation (ISC)
| Patient characteristics | Group 1 ≥ 60 years Formal ISC present n = 250 |
Group 2 ≥ 60 years Formal ISC absent n = 36 |
Group 3 < 60 years Formal ISC present n = 270 |
Group 1 vs. group 2 | Group 1 vs. group 3 | ||
|---|---|---|---|---|---|---|---|
| OR (95% CI) | p value | OR (95% CI) | p value | ||||
| Demographics | |||||||
| Male sex | 144 (58) | 23 (64) | 182 (67) | 0.77 (0.37–1.59) | 0.47 | 0.65 (0.46–0.94) | 0.21 |
| Age, yearsa | 72.6 ± 7.6 | 71.1 ± 7.9 | 43.0 ± 12.3 | – | 0.29 | – | < 0.001 |
| Healthcare-acquired | 157 (63) | 19 (53) | 118 (44) | 1.51 (0.75–3.05) | 0.25 | 2.18 (1.53–3.09) | < 0.001 |
| Previous hospitalizationb | 154 (62) | 25 (69) | 114 (42) | 0.71 (0.33–1.50) | 0.36 | 2.19 (1.55–3.12) | < 0.001 |
| Healthy-nonfatalc | 153 (61) | 19 (53) | 230 (85) | 1.41 (0.69–2.85) | 0.34 | 0.27 (0.18–0.42) | < 0.001 |
| Severe sepsisd | 21 (8) | 5 (14) | 18 (7) | 0.57 (0.20–1.62) | 0.28 | 1.28 (0.67–2.47) | 0.45 |
| Infection foci | |||||||
| Deep infections | 200 (80) | 19 (53) | 222 (82) | 3.58 (1.74–7.38) | < 0.001 | 0.87 (0.56–1.34) | 0.52 |
| Pneumonia | 99 (40) | 12 (33) | 103 (38) | 1.31 (0.63–2.74) | 0.47 | 1.06 (0.75–1.51) | 0.73 |
| Endocarditis | 39 (16) | 2 (6) | 47 (17) | 3.14 (0.73–13.6) | 0.11 | 0.88 (0.55–1.39) | 0.58 |
| Osteomyelitise | 94 (38) | 3 (8) | 110 (41) | 6.63 (1.98–22.2) | 0.001 | 0.87 (0.61–1.24) | 0.44 |
| Deep abscesses | 85 (34) | 2 (6) | 143 (53) | 8.76 (2.05–37.3) | 0.001 | 0.46 (0.32–0.65) | 0.001 |
| Any foreign body infection | 59 (24) | 4 (11) | 27 (10) | 2.47 (0.84–7.27) | 0.09 | 2.78 (1.69–4.55) | 0.001 |
| Infected PVC or CVCf | 45 (18) | 0 | 32 (12) | – | – | 1.48 (0.89–2.44) | 0.12 |
| Clinical management | |||||||
| TTE echocardiographyg | 165 (66) | 19 (53) | 174 (64) | 1.74 (0.86–3.51) | 0.12 | 1.07 (0.75–1.54) | 0.71 |
| TEE echocardiographyg | 55 (22) | 2 (6) | 54 (21) | 4.79 (1.12–20.6) | 0.021 | 1.13 (0.74–1.72) | 0.58 |
| Any infection foci removal | 84 (34) | 0 | 94 (36) | – | – | 0.95 (0.66–1.36) | 0.77 |
| Heart valve replacement | 2 (< 1) | 0 | 4 (1) | – | – | 0.54 (0.09–2.95) | 0.47 |
| Infected joint lavage | 7 (3) | 0 | 6 (2) | – | – | 1.27 (0.42–3.82) | 0.67 |
| Standard antibiotics | |||||||
| Cloxacillin | 163 (65) | 0 | 165 (61) | – | – | 1.19 (0.83–1.70) | 0.33 |
| Cephalosporin | 70 (28) | 27 (75) | 85 (31) | 0.13 (0.06–0.29) | < 0.001 | 0.85 (0.58–1.23) | 0.39 |
| Other antibiotics | 17 (7) | 9 (25) | 20 (7) | 4.57 (1.87–11.2) | < 0.001 | 1.09 (0.56–2.14) | 0.79 |
| Treatment durationh | 24.6 ± 13 | 19.8 ± 15 | 26.1 ± 12 | – | 0.038 | – | 0.19 |
| Adjunctive antibiotics | |||||||
| Fluoroquinolone | 129 (52) | 11 (31) | 136 (50) | 2.42 (1.14–5.14) | 0.018 | 1.05 (0.75–1.48) | 0.78 |
| Rifampicin | 152 (61) | 11 (31) | 175 (65) | 3.53 (1.66–7.49) | 0.001 | 0.84 (0.59–1.20) | 0.34 |
| Outcome | |||||||
| Hospital durationh | 38.7 ± 34 | 31.6 ± 26 | 32.7 ± 29 | – | 0.09 | – | 0.10 |
| Mortality in 28 days | 46 (18) | 11 (31) | 12 (4) | 0.51 (0.24–1.12) | 0.088 | 4.85 (2.50–9.39) | < 0.001 |
| Mortality in 90 days | 61 (24) | 17 (47) | 21 (8) | 0.36 (0.18–0.74) | 0.004 | 3.83 (2.25–6.51) | < 0.001 |
Altogether 61 (18%) patients were aged < 60 years and received no formal ISC and are omitted in the presentation. Values are expressed as number of patients (%), odds ratios (ORs) with 95% confidence intervals (CI) and mean ± standard deviation (SD)
aStudent’s t test (mean ± SD)
bWithin 2 months preceding SAB
cMcCabe’s classification [20]
dAt blood culture collection
eIncluding septic arthritis
fPeripheral or central venous catheter
gThoracic or –esophageal
hDays (mean ± SD)