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J Hosp Infect ; 152: 13-20, 2024 Oct.
Article in English | MEDLINE | ID: mdl-39032565

ABSTRACT

BACKGROUND: Peripheral venous catheter-associated Staphylococcus aureus bacteraemia (PVC-SAB) is a potentially life-threatening nosocomial infection. AIM: This cohort study aims to identify the risk factors associated with its mortality and complications. METHODS: Retrospective analysis of a prospective cohort study conducted at two tertiary-care hospitals in Spain. Adult patients admitted between January 2011 and July 2019 which developed PVC-SAB during their hospital stay were included. Primary outcome was all-cause 30- and 90-day mortality. Secondary outcomes were sepsis or septic shock at the onset of bacteraemia, metastatic infection and length of hospital stay. Univariate and multivariate analyses were performed. FINDINGS: A total of 256 PVC-SAB were diagnosed in 243 patients between 2011 and 2019. Thirty-day and 90-day all-cause mortality were 18.3% and 24.2%, respectively. Lack of susceptible antibiotic administration the day after blood culture collection (odds ratio: 4.14; 95% confidence interval: 1.55-11.03; P = 0.005), sepsis and complicated bacteraemia were identified as independent risk factors for 30- and 90-day mortality; meticillin-resistant S. aureus bacteraemia was identified as an independent risk factor only for 30-day mortality and functional dependence only for 90-day mortality. Persistent bacteraemia and sepsis were associated with septic metastases, which significantly increased hospital stay, and endocarditis. A greater proportion of patients experiencing septic shock were subsequently institutionalized compared to those without. CONCLUSION: PVC-SAB remains linked to high mortality rates. Prompt administration of appropriate antibiotics is crucial for lowering mortality. A comprehensive diagnostic approach is essential, especially in patients with persistent bacteraemia and implanted cardiovascular devices, to rule out metastatic complications and endocarditis.


Subject(s)
Bacteremia , Catheter-Related Infections , Staphylococcal Infections , Staphylococcus aureus , Humans , Male , Female , Risk Factors , Staphylococcal Infections/mortality , Staphylococcal Infections/microbiology , Bacteremia/mortality , Bacteremia/microbiology , Middle Aged , Aged , Spain/epidemiology , Catheter-Related Infections/mortality , Catheter-Related Infections/microbiology , Retrospective Studies , Staphylococcus aureus/isolation & purification , Prospective Studies , Tertiary Care Centers/statistics & numerical data , Adult , Aged, 80 and over , Cross Infection/mortality , Cross Infection/microbiology , Catheterization, Peripheral/adverse effects
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