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Observational Study
. 2020 May 27;9(1):76.
doi: 10.1186/s13756-020-00741-6.

Clinical characteristics and risk factors of polymicrobial Staphylococcus aureus bloodstream infections

Cheng Zheng #  1   2 , Shufang Zhang #  3 , Qingqing Chen #  4 , Li Zhong  1   5 , Tiancha Huang  1 , Xijiang Zhang  2 , Kai Zhang  1 , Hongwei Zhou  6 , Jiachang Cai  6 , Linlin Du  1 , Changming Wang  2 , Wei Cui  1 , Gensheng Zhang  7
Affiliations
Observational Study

Clinical characteristics and risk factors of polymicrobial Staphylococcus aureus bloodstream infections

Cheng Zheng et al. Antimicrob Resist Infect Control. .

Erratum in

Abstract

Background: Although Staphylococcus aureus bloodstream infections (SA-BSI) are a common and important infection, polymicrobial SA-BSI are infrequently reported. The aim of this study was to investigate the clinical characteristics and risk factors of polymicrobial SA-BSI in comparison with monomicrobial SA-BSI.

Methods: A single-center retrospective observational study was performed between Jan 1, 2013, and Dec 31, 2018 at a tertiary hospital. All patients with SA-BSI were enrolled, and their clinical data were gathered by reviewing electronic medical records.

Results: A total of 349 patients with SA-BSI were enrolled including 54 cases (15.5%) with polymicrobial SA-BSI. In multivariable analysis, burn injury (adjusted odds ratio [OR], 7.04; 95% confidence interval [CI], 1.71-28.94), need of blood transfusion (aOR, 2.72; 95% CI, 1.14-6.50), use of mechanical ventilation (aOR, 3.11; 95% CI, 1.16-8.30), the length of prior hospital stay (aOR, 1.02; 95% CI, 1.00-1.03), and pneumonia as primary site of infection (aOR, 4.22; 95% CI, 1.69-10.51) were independent factors of polymicrobial SA-BSI. In comparison with monomicrobial SA-BSI, patients with polymicrobial SA-BSI had longer length of ICU stay [median days, 23(6.25,49.25) vs. 0(0,12), p < 0.01] and hospital stay [median days, 50(21.75,85.75) vs. 28(15,49), p < 0.01], and showed a higher 28-day mortality (29.6% vs. 15.3%, p = 0.01).

Conclusions: Burn injury, blood transfusion, mechanical ventilation, the length of prior hospital stay, and pneumonia as a primary site of infection are independent risk factors for polymicrobial SA-BSI. In addition, patients with polymicrobial SA-BSI might have worse outcomes compared with monomicrobial SA-BSI.

Keywords: Bacteremia; Mortality; Polymicrobial Staphylococcus aureus bloodstream infections; Risk factors; Staphylococcus aureus.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of study participant enrollment. Abbreviations: SA-BSI, Staphylococcus aureus bloodstream infections
Fig. 2
Fig. 2
Distribution of the additional organisms in polymicrobial Staphylococcus aureus bloodstream infections. Abbreviations: E. coli, Escherichia coli; A. baumannii, Acinetobacter baumannii; CNS, Coagulase-negative Staphylococcus; K. pneumoniae, Klebsiella pneumoniae; P. aeruginosa, Pseudomonas aeruginosa; P. maltophilia, Pseudomonas maltophilia
Fig. 3
Fig. 3
Kaplan-Meier estimates of survival in patients with polymicrobial Staphylococcus aureus bloodstream infections and monomicrobial Staphylococcus aureus bloodstream infections. Abbreviations: SA-BSI, Staphylococcus aureus bloodstream infections
See this image and copyright information in PMC

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