- 作者：Seong Yeon Park ; Ki-Ho Park ; Kyung Mi Bang ; Yong Pil Chong ; Sung-Han Kim ; Sang-Oh Lee ; Sang-Ho Choi ; Jin-Young Jeong ; Jun Hee Woo ; Yang Soo Kim
- 关键词：Polymicrobial bacteremia ; Staphylococcus aureus
- 刊名：Journal of Infection
- 出版年：2012
- 出版时间：August, 2012
- 年：2012
- 卷：65
- 期：2
- 页码：119-127
- 全文大小：309 K
Summary
Objectives
The clinical significance of polymicrobial Staphylococcus aureus bacteremia (SAB) remains unclear. We therefore compared the clinical features and outcomes of polymicrobial and monomicrobial SAB.Methods
A prospective cohort study of patients with SAB was performed during a 20-months. Polymicrobial SAB was defined as the simultaneous isolation of S. aureus and other microorganisms from blood cultures. However, Corynebacterium spp., Bacillus spp., and coagulase-negative staphylococci were considered contaminants unless they were related to device infection and grew in two or more blood cultures.
Results
During the study period, 44 (10 % ) patients had polymicrobial and 412 (90 % ) had monomicrobial SAB. A total of 54 microorganisms were isolated from the former, with Enterococcus spp. (22 % ) being the most common. Independent risk factors for polymicrobial SAB included neutropenia (odds ratio [OR] 3.5, p?=?0.02), biliary tract catheters (OR 5.0, p?=?0.001), and intra-abdominal infection (OR 10.3, p?<?0.001). Clinical outcomes were significantly worse among patients with polymicrobial than monomicrobial SAB, including bacteremia-related and 7-day mortality rates. Independent predictors of bacteremia-related mortality were solid tumors (HR 2.0, p?=?0.03) and polymicrobial SAB (HR 2.8, p?=?0.007).
Conclusions
Polymicrobial SAB is associated with more severe illness than monomicrobial SAB, with neutropenia, biliary tract catheters and intra-abdominal infection being significant risk factors for polymicrobial SAB.