TABLE 4.
Predictors for 90-day mortality from initial positive blood culture among 416 Staphylococcus aureus bacteremia episodesa
| Variable, n (%) or median (IQR) | Survived (n = 282) | Died (n= 134) | Crude OR (95% CI) | Adjusted ORb (95% CI) |
|---|---|---|---|---|
| Age, yrs | 56 (39–67) | 62.5 (51–71) | 1.03 (1.01–1.04) | 1.03 (1.02–1.05) |
| Sex, male | 173 (61) | 76 (57) | 0.83 (0.54–1.25) | |
| Charlson comorbidity index | 5 (3–8) | 6 (3–8) | 1.02 (0.96–1.09) | |
| ICU admission within 48 h of index BC | 131 (46) | 63 (47) | 1.02 (0.68–1.54) | |
| ICU admission during hospitalization | 158 (56) | 73 (54) | 0.94 (0.62–1.42) | |
| MRSA bacteremia | 114 (40) | 54 (40) | 0.99 (0.65–1.51) | |
| Bacteremia onset, community-onset | 196 (70) | 87 (65) | 0.81 (0.53–1.26) | |
| Postimplementation period | 163 (58) | 77 (57) | 0.98 (0.65–1.5) | |
| Site of infection | ||||
| Isolated bacteremia | 59 (21) | 29 (22) | 1.04 (0.63–1.72) | |
| Central line-associated bacteremia | 61 (22) | 37 (28) | 1.38 (0.86–2.22) | |
| Skin and soft tissue infection | 34 (12) | 20 (15) | 1.28 (0.71–2.32) | |
| Osteomyelitis | 43 (15) | 11 (8) | 0.5 (0.25–1) | 0.43 (0.21–0.89) |
| Septic arthritis | 23 (8) | 5 (4) | 0.44 (0.16–1.17) | |
| Epidural abscess | 10 (4) | 3 (2) | 0.62 (0.17–2.3) | |
| Endocarditis | 45 (16) | 23 (17) | 1.09 (0.63–1.89) | |
| Vascular graft infection | 7 (2) | 7 (5) | 2.17 (0.74–6.3) | |
| Lower respiratory tract infection | 23 (8) | 23 (17) | 2.33 (1.26–4.33) | 2.2 (1.13–4.11) |
| Cardiac device associated infection | 14 (5) | 6 (4) | 0.9 (0.34–2.39) | |
| Bacteremia duration, intermediate/prolonged (≥3 days) | 116 (41) | 61 (46) | 1.2 (0.79–1.81) | |
| Time to positivity of index BC, hours | 16 (12–21) | 14 (11–20) | 1 (0.99–1.02) | |
| Source removed/controlled | 141 (50) | 50 (37) | 0.6 (0.39–0.91) | |
| Time from index BC to source control, days | 3 (1–6) | 3.5 (1–6) | 1.02 (0.97–1.07) | |
| Initial antistaphylococcal therapy | ||||
| Vancomycin | 230 (82) | 100 (75) | 0.66 (0.41–1.09) | |
| Daptomycin | 6 (2) | 1 (1) | 0.35 (0.04–2.9) | |
| Linezolid | 11 (4) | 10 (7) | 1.99 (0.82–4.8) | |
| Cefazolin | 6 (2) | 3 (2) | 1.05 (0.26–4.3) | |
| Antistaphylococcal penicillin | 6 (2) | 2 (1) | 0.7 (0.14–3.5) | |
| Definitive antistaphylococcal therapy | ||||
| Vancomycin | 74 (26) | 39 (29) | 1.15 (0.73–1.82) | |
| Daptomycin | 39 (14) | 16 (12) | 0.84 (0.45–1.57) | |
| Linezolid | 5 (2) | 8 (6) | 3.52 (1.13–10.97) | 3.79 (1.15–12.51) |
| Cefazolin | 58 (21) | 27 (20) | 0.97 (0.58–1.63) | |
| Antistaphylococcal penicillin | 50 (18) | 18 (13) | 0.72 (0.4–1.29) | |
| Ceftriaxone | 54 (19) | 25 (19) | 0.97 (0.57–1.64) | |
| Combination antistaphylococcal therapy | 29 (10) | 20 (15) | 1.53 (0.83–2.82) |
a
IQR, interquartile range; OR, odds ratio; CI, confidence intervals; BC, blood culture; ICU, intensive care unit; MRSA, methicillin-resistant S. aureus.
b
Variables included for consideration in the logistic regression model were age, osteomyelitis, lower respiratory tract infection, source removed/controlled, and linezolid use as definitive antistaphylococcal therapy.