Factors associated with 12 week case-fatality in Staphylococcus aureus bacteraemia: a prospective cohort study.
Identifieur interne : 000070 ( France/Analysis ); précédent : 000069; suivant : 000071Factors associated with 12 week case-fatality in Staphylococcus aureus bacteraemia: a prospective cohort study.
Auteurs : P. Braquet [France] ; F. Alla [France] ; C. Cornu [France] ; F. Goehringer [France] ; L. Piroth [France] ; C. Chirouze [France] ; M. Revest [France] ; C. Lechiche [France] ; X. Duval [France] ; V. Le Moing [France]Source :
- Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases [ 1469-0691 ] ; 2016.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Analyse de survie, Bactériémie (mortalité), Bactériémie (traitement médicamenteux), Bactériémie (épidémiologie), Centres de soins tertiaires, Femelle, France (épidémiologie), Humains, Infection croisée (mortalité), Infection croisée (épidémiologie), Infections à staphylocoques (mortalité), Infections à staphylocoques (traitement médicamenteux), Infections à staphylocoques (épidémiologie), Mâle, Pronostic, Pénicillines (administration et posologie), Pénicillines (usage thérapeutique), Staphylococcus aureus, Sujet âgé, Vancomycine (administration et posologie), Vancomycine (usage thérapeutique), Études prospectives.
- MESH :
- administration et posologie : Pénicillines, Vancomycine.
- mortalité : Bactériémie, Infection croisée, Infections à staphylocoques.
- traitement médicamenteux : Bactériémie, Infections à staphylocoques.
- usage thérapeutique : Pénicillines, Vancomycine.
- épidémiologie : Bactériémie, France, Infection croisée, Infections à staphylocoques.
- Adulte d'âge moyen, Analyse de survie, Centres de soins tertiaires, Femelle, Humains, Mâle, Pronostic, Staphylococcus aureus, Sujet âgé, Études prospectives.
English descriptors
- KwdEn :
- Aged, Bacteremia (drug therapy), Bacteremia (epidemiology), Bacteremia (mortality), Cross Infection (epidemiology), Cross Infection (mortality), Female, France (epidemiology), Humans, Male, Middle Aged, Penicillins (administration & dosage), Penicillins (therapeutic use), Prognosis, Prospective Studies, Staphylococcal Infections (drug therapy), Staphylococcal Infections (epidemiology), Staphylococcal Infections (mortality), Staphylococcus aureus, Survival Analysis, Tertiary Care Centers, Vancomycin (administration & dosage), Vancomycin (therapeutic use).
- MESH :
- chemical , administration & dosage : Penicillins, Vancomycin.
- drug therapy : Bacteremia, Staphylococcal Infections.
- epidemiology : Bacteremia, Cross Infection, France, Staphylococcal Infections.
- mortality : Bacteremia, Cross Infection, Staphylococcal Infections.
- chemical , therapeutic use : Penicillins, Vancomycin.
- Aged, Female, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Staphylococcus aureus, Survival Analysis, Tertiary Care Centers.
Abstract
Staphylococcus aureus bacteraemia (SAB) is a frequent and deadly disease. Given the lack of a randomized trial, optimal first-line antibiotic treatment is still debated. Our aim was to identify prognostic factors in SAB patients and to analyse the impact of first-line antibiotics. The VIRSTA prospective cohort study was conducted in eight tertiary care centres in France. Consecutive incident adults in whom a blood culture drawn in participating centres grew S. aureus between April 2009 and October 2011 were prospectively followed for 12 weeks. Factors associated with 12-week case-fatality were identified by multivariate logistic regression. We enrolled 2091 patients and analysed survival in 1972 (median age 67.8 years, interquartile range 55.5-78.9; females 692/1972, 35.1%). SAB was nosocomial or healthcare-related in 1372/1972 (69.6%) of cases and the primary focus was unknown in 414/1972 (21.0%) of cases. Week 12 case-fatality rate was 671/1972 (34.0%). The main independent prognostic factors on multivariate analysis were age (adjusted OR by 10-year increment 1.56; 95% CI 1.44-1.69), septic shock (OR 5.11; 95% CI 3.84-6.80), metastatic cancer (OR 4.28; 95% CI 2.88-6.38), and unknown primary focus (OR 2.62; 95% CI 2.02-3.41). In the 1538 patients with methicillin-sensitive S. aureus (MSSA) bacteraemia, first-line empiric antistaphylococcal penicillins (OR 0.40; 95% CI 0.17-0.95) and vancomycin (OR 0.37; 95% CI 0.17-0.83), alone or combined with an aminoglycoside, were associated with better outcome compared with other antibiotics. There are few modifiable prognostic factors for SAB. Initiating empiric antibiotics with antistaphylococcal penicillins or vancomycin may be associated with better outcome in MSSA bacteraemia.
DOI: 10.1016/j.cmi.2016.07.034
PubMed: 27515395
Affiliations:
- France
- Auvergne-Rhône-Alpes, Bourgogne, Bourgogne-Franche-Comté, Franche-Comté, Grand Est, Languedoc-Roussillon, Lorraine (région), Occitanie (région administrative), Rhône-Alpes, Île-de-France
- Besançon, Dijon, Lyon, Montpellier, Nancy, Nîmes, Paris
- Université de Bourgogne, Université de Lorraine
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pubmed:27515395Le document en format XML
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Braquet</name><affiliation wicri:level="3"><nlm:affiliation>Department for Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de Montpellier, Montpellier, France; UMI 233 TransVIHMI, Université de Montpellier, Institut de Recherche sur le Développement, Montpellier, France. Electronic address: pit.braquet@gmail.com.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department for Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de Montpellier, Montpellier, France; UMI 233 TransVIHMI, Université de Montpellier, Institut de Recherche sur le Développement, Montpellier</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Languedoc-Roussillon</region><settlement type="city">Montpellier</settlement></placeName></affiliation></author><author><name sortKey="Alla, F" sort="Alla, F" uniqKey="Alla F" first="F" last="Alla">F. Alla</name><affiliation wicri:level="4"><nlm:affiliation>Université de Lorraine, Université Paris Descartes, Apemac, EA 4360, Nancy, France; INSERM, CIC-EC, CIE6, Nancy, France; CHU Nancy, Nancy, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université de Lorraine, Université Paris Descartes, Apemac, EA 4360, Nancy, France; INSERM, CIC-EC, CIE6, Nancy, France; CHU Nancy, Nancy</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Lorraine (région)</region><settlement type="city">Nancy</settlement></placeName><orgName type="university">Université de Lorraine</orgName></affiliation></author><author><name sortKey="Cornu, C" sort="Cornu, C" uniqKey="Cornu C" first="C" last="Cornu">C. Cornu</name><affiliation wicri:level="3"><nlm:affiliation>INSERM, CIC1407, Lyon, France; CHU Lyon, Service de Pharmacologie Clinique, Lyon, France; Université Lyon, UMR 5558, Lyon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>INSERM, CIC1407, Lyon, France; CHU Lyon, Service de Pharmacologie Clinique, Lyon, France; Université Lyon, UMR 5558, Lyon</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation></author><author><name sortKey="Goehringer, F" sort="Goehringer, F" uniqKey="Goehringer F" first="F" last="Goehringer">F. Goehringer</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de Nancy, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de Nancy</wicri:regionArea><wicri:noRegion>Centre Hospitalier Universitaire de Nancy</wicri:noRegion><wicri:noRegion>Centre Hospitalier Universitaire de Nancy</wicri:noRegion></affiliation></author><author><name sortKey="Piroth, L" sort="Piroth, L" uniqKey="Piroth L" first="L" last="Piroth">L. Piroth</name><affiliation wicri:level="4"><nlm:affiliation>CHU de Dijon, UMR 1347-MERS, Université de Bourgogne, Dijon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>CHU de Dijon, UMR 1347-MERS, Université de Bourgogne, Dijon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Bourgogne</region><settlement type="city">Dijon</settlement></placeName><orgName type="university">Université de Bourgogne</orgName></affiliation></author><author><name sortKey="Chirouze, C" sort="Chirouze, C" uniqKey="Chirouze C" first="C" last="Chirouze">C. Chirouze</name><affiliation wicri:level="3"><nlm:affiliation>UMR CNRS 6249 Chrono-environnement, Université de Bourgogne Franche-Comté, CHU de Besançon, Besançon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>UMR CNRS 6249 Chrono-environnement, Université de Bourgogne Franche-Comté, CHU de Besançon, Besançon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation></author><author><name sortKey="Revest, M" sort="Revest, M" uniqKey="Revest M" first="M" last="Revest">M. Revest</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Diseases and Intensive Care Unit, Centre Hospitalier Universitaire de Rennes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Infectious Diseases and Intensive Care Unit, Centre Hospitalier Universitaire de Rennes</wicri:regionArea><wicri:noRegion>Centre Hospitalier Universitaire de Rennes</wicri:noRegion><wicri:noRegion>Centre Hospitalier Universitaire de Rennes</wicri:noRegion></affiliation></author><author><name sortKey="Lechiche, C" sort="Lechiche, C" uniqKey="Lechiche C" first="C" last="Lechiche">C. Lechiche</name><affiliation wicri:level="3"><nlm:affiliation>Department for Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de Nîmes, Nîmes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department for Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de Nîmes, Nîmes</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Languedoc-Roussillon</region><settlement type="city">Nîmes</settlement></placeName></affiliation></author><author><name sortKey="Duval, X" sort="Duval, X" uniqKey="Duval X" first="X" last="Duval">X. Duval</name><affiliation wicri:level="3"><nlm:affiliation>Université Paris Diderot Sorbonne, Paris, France; IAME, INSERM, UMR 1137, CIC 1425, Paris, France; AP-HP, Hôpital Bichat Claude Bernard, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université Paris Diderot Sorbonne, Paris, France; IAME, INSERM, UMR 1137, CIC 1425, Paris, France; AP-HP, Hôpital Bichat Claude Bernard, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Le Moing, V" sort="Le Moing, V" uniqKey="Le Moing V" first="V" last="Le Moing">V. Le Moing</name><affiliation wicri:level="3"><nlm:affiliation>Department for Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de Montpellier, Montpellier, France; UMI 233 TransVIHMI, Université de Montpellier, Institut de Recherche sur le Développement, Montpellier, France. Electronic address: v-le_moing@chu-montpellier.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department for Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de Montpellier, Montpellier, France; UMI 233 TransVIHMI, Université de Montpellier, Institut de Recherche sur le Développement, Montpellier</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Languedoc-Roussillon</region><settlement type="city">Montpellier</settlement></placeName></affiliation></author></analytic><series><title level="j">Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases</title><idno type="eISSN">1469-0691</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Bacteremia (drug therapy)</term><term>Bacteremia (epidemiology)</term><term>Bacteremia (mortality)</term><term>Cross Infection (epidemiology)</term><term>Cross Infection (mortality)</term><term>Female</term><term>France (epidemiology)</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Penicillins (administration & dosage)</term><term>Penicillins (therapeutic use)</term><term>Prognosis</term><term>Prospective Studies</term><term>Staphylococcal Infections (drug therapy)</term><term>Staphylococcal Infections (epidemiology)</term><term>Staphylococcal Infections (mortality)</term><term>Staphylococcus aureus</term><term>Survival Analysis</term><term>Tertiary Care Centers</term><term>Vancomycin (administration & dosage)</term><term>Vancomycin (therapeutic use)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Analyse de survie</term><term>Bactériémie (mortalité)</term><term>Bactériémie (traitement médicamenteux)</term><term>Bactériémie (épidémiologie)</term><term>Centres de soins tertiaires</term><term>Femelle</term><term>France (épidémiologie)</term><term>Humains</term><term>Infection croisée (mortalité)</term><term>Infection croisée (épidémiologie)</term><term>Infections à staphylocoques (mortalité)</term><term>Infections à staphylocoques (traitement médicamenteux)</term><term>Infections à staphylocoques (épidémiologie)</term><term>Mâle</term><term>Pronostic</term><term>Pénicillines (administration et posologie)</term><term>Pénicillines (usage thérapeutique)</term><term>Staphylococcus aureus</term><term>Sujet âgé</term><term>Vancomycine (administration et posologie)</term><term>Vancomycine (usage thérapeutique)</term><term>Études prospectives</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Penicillins</term><term>Vancomycin</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Pénicillines</term><term>Vancomycine</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Bacteremia</term><term>Staphylococcal Infections</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Bacteremia</term><term>Cross Infection</term><term>France</term><term>Staphylococcal Infections</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Bacteremia</term><term>Cross Infection</term><term>Staphylococcal Infections</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Bactériémie</term><term>Infection croisée</term><term>Infections à staphylocoques</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Penicillins</term><term>Vancomycin</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Bactériémie</term><term>Infections à staphylocoques</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Pénicillines</term><term>Vancomycine</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Bactériémie</term><term>France</term><term>Infection croisée</term><term>Infections à staphylocoques</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prognosis</term><term>Prospective Studies</term><term>Staphylococcus aureus</term><term>Survival Analysis</term><term>Tertiary Care Centers</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Analyse de survie</term><term>Centres de soins tertiaires</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Pronostic</term><term>Staphylococcus aureus</term><term>Sujet âgé</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Staphylococcus aureus bacteraemia (SAB) is a frequent and deadly disease. Given the lack of a randomized trial, optimal first-line antibiotic treatment is still debated. Our aim was to identify prognostic factors in SAB patients and to analyse the impact of first-line antibiotics. The VIRSTA prospective cohort study was conducted in eight tertiary care centres in France. Consecutive incident adults in whom a blood culture drawn in participating centres grew S. aureus between April 2009 and October 2011 were prospectively followed for 12 weeks. Factors associated with 12-week case-fatality were identified by multivariate logistic regression. We enrolled 2091 patients and analysed survival in 1972 (median age 67.8 years, interquartile range 55.5-78.9; females 692/1972, 35.1%). SAB was nosocomial or healthcare-related in 1372/1972 (69.6%) of cases and the primary focus was unknown in 414/1972 (21.0%) of cases. Week 12 case-fatality rate was 671/1972 (34.0%). The main independent prognostic factors on multivariate analysis were age (adjusted OR by 10-year increment 1.56; 95% CI 1.44-1.69), septic shock (OR 5.11; 95% CI 3.84-6.80), metastatic cancer (OR 4.28; 95% CI 2.88-6.38), and unknown primary focus (OR 2.62; 95% CI 2.02-3.41). In the 1538 patients with methicillin-sensitive S. aureus (MSSA) bacteraemia, first-line empiric antistaphylococcal penicillins (OR 0.40; 95% CI 0.17-0.95) and vancomycin (OR 0.37; 95% CI 0.17-0.83), alone or combined with an aminoglycoside, were associated with better outcome compared with other antibiotics. There are few modifiable prognostic factors for SAB. Initiating empiric antibiotics with antistaphylococcal penicillins or vancomycin may be associated with better outcome in MSSA bacteraemia.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Auvergne-Rhône-Alpes</li><li>Bourgogne</li><li>Bourgogne-Franche-Comté</li><li>Franche-Comté</li><li>Grand Est</li><li>Languedoc-Roussillon</li><li>Lorraine (région)</li><li>Occitanie (région administrative)</li><li>Rhône-Alpes</li><li>Île-de-France</li></region><settlement><li>Besançon</li><li>Dijon</li><li>Lyon</li><li>Montpellier</li><li>Nancy</li><li>Nîmes</li><li>Paris</li></settlement><orgName><li>Université de Bourgogne</li><li>Université de Lorraine</li></orgName></list><tree><country name="France"><region name="Occitanie (région administrative)"><name sortKey="Braquet, P" sort="Braquet, P" uniqKey="Braquet P" first="P" last="Braquet">P. Braquet</name></region><name sortKey="Alla, F" sort="Alla, F" uniqKey="Alla F" first="F" last="Alla">F. Alla</name><name sortKey="Chirouze, C" sort="Chirouze, C" uniqKey="Chirouze C" first="C" last="Chirouze">C. Chirouze</name><name sortKey="Cornu, C" sort="Cornu, C" uniqKey="Cornu C" first="C" last="Cornu">C. Cornu</name><name sortKey="Duval, X" sort="Duval, X" uniqKey="Duval X" first="X" last="Duval">X. Duval</name><name sortKey="Goehringer, F" sort="Goehringer, F" uniqKey="Goehringer F" first="F" last="Goehringer">F. Goehringer</name><name sortKey="Le Moing, V" sort="Le Moing, V" uniqKey="Le Moing V" first="V" last="Le Moing">V. Le Moing</name><name sortKey="Lechiche, C" sort="Lechiche, C" uniqKey="Lechiche C" first="C" last="Lechiche">C. Lechiche</name><name sortKey="Piroth, L" sort="Piroth, L" uniqKey="Piroth L" first="L" last="Piroth">L. Piroth</name><name sortKey="Revest, M" sort="Revest, M" uniqKey="Revest M" first="M" last="Revest">M. Revest</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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