The Management of Staphylococcus aureus Bacteremia in the United Kingdom and Vietnam: A Multi-Centre Evaluation
نویسنده
چکیده
BACKGROUND Staphylococcus aureus bacteremia is a common and serious infection worldwide and although treatment guidelines exist, there is little consensus on optimal management. In this study we assessed the variation in management and adherence to treatment guidelines of S. aureus bacteremia. METHODOLOGY/PRINCIPAL FINDINGS We prospectively recorded baseline clinical characteristics, management, and in-hospital outcome of all adults with S. aureus bacteremia treated consecutively over one year in eight centres in the United Kingdom, three in Vietnam and one in Nepal. 630 adults were treated for S. aureus bacteremia: 549 in the UK (21% methicillin-resistant), 80 in Vietnam (19% methicillin-resistant) and 1 in Nepal. In the UK, 41% had a removable infection focus (50% intravenous catheter-related), compared to 12% in Vietnam. Significantly (p<0.001) higher proportions of UK than Vietnamese patients had an echocardiogram (50% versus 28%), received more than 14 days antibiotic therapy (84% versus 44%), and received >50% of treatment with oral antibiotics alone (25% versus 4%). UK centres varied significantly (p<0.01) in the proportions given oral treatment alone for >50% of treatment (range 12-40%), in those treated for longer than 28 days (range 13-54%), and in those given combination therapy (range 14-94%). 24% died during admission: older age, time in hospital before bacteremia, and an unidentified infection focus were independent predictors of in-hospital death (p<0.001). CONCLUSIONS/SIGNIFICANCE The management of S. aureus bacteremia varies widely between the UK and Vietnam and between centres in the UK with little adherence to published guidelines. Controlled trials defining optimal therapy are urgently required.
منابع مشابه
A multi - center study evaluating the current strategies for isolating 1 Staphylococcus aureus strains with reduced susceptibility to glycopeptides 2 3 Evaluation of GISA /
2 Bristol Centre for Antimicrobial Research and Evaluation (BCARE), Medical 10 Microbiology, Southmead Hospital, North Bristol Healthcare Trust, Bristol, BS10 11 5NB, United Kingdom. 3 Department of Medical Microbiology, School of Medicine, 12 Cardiff University, Heath Park, Cardiff, CF14 4XN, United Kingdom. 13 14 15 16 17
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عنوان ژورنال:
دوره 5 شماره
صفحات -
تاریخ انتشار 2010