Table 2.
Comparisons of demographic and clinical features between patients with methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia with favorable and unfavorable final clinical responses
| Outcome at the end of the initial treatment | Favorable outcome n = 67 |
Unfavorable outcome n = 17 |
P |
|---|---|---|---|
| Demographics | |||
| Male gender, n (%) | 43 (64.2) | 11 (64.7) | > 0.99 |
| Age, mean (IQR), years | 68 (59–77) | 72 (48–85) | 0.82 |
| MIC of teicoplanin ≥ 1.5 mg/L, n (%) | 22 (32.8) | 7 (41.2) | 0.57 |
| Co-morbidities, n (%) | |||
| Coronary artery disease | 14 (20.9) | 3 (17.6) | > 0.99 |
| Diabetes mellitus | 30 (44.8) | 4 (23.5) | 0.17 |
| Hypertension | 38 (56.7) | 5 (29.4) | 0.06 |
| Solid tumor | 14 (20.9) | 5 (29.4) | 0.52 |
| Hematology malignancy | 1 (1.5) | 0 | > 0.99 |
| Liver cirrhosis | 4 (6.0) | 3 (17.6) | 0.14 |
| Chronic obstructive pulmonary disease | 5 (7.5) | 2 (11.8) | 0.63 |
| IV drug abuser | 2 (3.0) | 2 (11.8) | 0.18 |
| Congestive heart failure | 13 (19.4) | 2 (11.8) | 0.73 |
| End-stage renal disease | 17 (25.4) | 3 (17.6) | 0.75 |
| Cerebral vascular accident | 21 (31.3) | 2 (11.8) | 0.14 |
| Prosthetic device implantation | 27 (40.3) | 5 (29.4) | 0.58 |
| Pittsburgh bacteremia score ≥ 4a | 14 (20.9) | 16 (94.1) | < 0.01* |
| Source of bacteremiab, n (%) | |||
| Catheter-related bacteremia | 15 (22.4) | 2 (11.8) | 0.50 |
| Bone and joint infection | 20 (29.9) | 1 (5.9) | 0.06 |
| Infective endocarditis | 2 (3.0) | 4 (23.5) | 0.01 |
| Skin and soft infection | 16 (23.9) | 1 (5.9) | 0.17 |
| Intra-abdominal infection | 0 | 1 (5.9) | 0.20 |
| Urinary tract infection | 1 (1.5) | 0 | > 0.99 |
| Pneumonia | 5 (7.5) | 3 (17.6) | 0.35 |
| Primary bacteremia | 6 (9.0) | 3 (17.6) | 0.38 |
| Adequate infection source control ratec n/N | 28/51 (54.9) | 2/4 (50.0) | > 0.99 |
| Initial treatment group, n (%) | |||
| Initial teicoplanin treatment group | 24 (35.8) | 4 (23.5) | 0.40 |
| Initial ß-lactam treatment group | 43 (64.2) | 13 (76.5) | 0.40 |
IQR interquartile range
aAt the time of blood sampling for culture
bPatients may have had more than one source of bacteremia
cSurgical intervention, drainage, central venous catheter removal, and urinary catheter removal were performed for source control. Patients with pneumonia or primary bacteremia were excluded. n: adequate and timely removal or debridement of the source of bacteremia, N: the source of bacteremia needed to be removed or debrided
*Multivariate analysis of the risk factors for an unfavorable clinical outcome in patients with MSSA bacteremia treated initially with teicoplanin or ß-lactam antibiotics showed that a Pittsburgh bacteremia score ≥ 4 (odd ratio, 60.6 [95% confidence interval, 7.4–496.8], p < 0.01) was an independent risk factor for an unfavorable outcome