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Type: Journal article
Title: Morbidity from in-hospital complications is greater than treatment failure in patients with Staphylococcus aureus bacteraemia
Author: Holmes, N.
Robinson, J.
van Hal, S.
Munckhof, W.
Athan, E.
Korman, T.
Cheng, A.
Turnidge, J.
Johnson, P.
Howden, B.
VANESSA study group
Citation: BMC Infectious Diseases, 2018; 18(1):107-1-107-9
Publisher: BioMed Central
Issue Date: 2018
ISSN: 1471-2334
Statement of
Natasha E. Holmes, J. Owen Robinson, Sebastiaan J. van Hal, Wendy J. Munckhof, Eugene Athan, Tony M. Korman, Allen C. Cheng, John D. Turnidge, Paul D. R. Johnson, Benjamin P. Howden, and VANESSA study group, on behalf of the Australasian Society for Infectious Diseases (ASID) Clinical Research Network (CRN)
Abstract: Background: Various studies have identified numerous factors associated with poor clinical outcomes in patients with Staphylococcus aureus bacteraemia (SAB). A new study was created to provide deeper insight into in-hospital complications and risk factors for treatment failure. Methods: Adult patients hospitalised with Staphylococcus aureus bacteraemia (SAB) were recruited prospectively into a multi-centre cohort. The primary outcome was treatment failure at 30 days (composite of all-cause mortality, persistent bacteraemia, or recurrent bacteraemia), and secondary measures included in-hospital complications and mortality at 6- and 12-months. Data were available for 222 patients recruited from February 2011 to December 2012. Results: Treatment failure at 30-days was recorded in 14.4% of patients (30-day mortality 9.5%). Multivariable analysis predictors of treatment failure included age > 70 years, Pitt bacteraemia score ≥ 2, CRP at onset of SAB > 250 mg/L, and persistent fevers after SAB onset; serum albumin at onset of SAB, receipt of appropriate empiric treatment, recent healthcare attendance, and performing echocardiography were protective. 6-month and 12-month mortality were 19.1% and 24.2% respectively. 45% experienced at least one in-hospital complication, including nephrotoxicity in 19.5%. Conclusions: This study demonstrates significant improvements in 30-day outcomes in SAB in Australia. However, we have identified important areas to improve outcomes from SAB, particularly reducing renal dysfunction and in-hospital treatment-related complications.
Keywords: Staphylococcus aureus; bacteraemia; treatment failure; complication; mortality
Description: Published online: 05 March 2018
Rights: © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
RMID: 0030083783
DOI: 10.1186/s12879-018-3011-2
Grant ID:
Appears in Collections:Molecular and Biomedical Science publications

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