Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 9;29(5):104573.
doi: 10.1016/j.bjid.2025.104573. Online ahead of print.

Severe Staphylococcus aureus infection: associated factors and outcomes

Narendra Babu Valobdás  1 , Marcelo Ribeiro Alves  1 , Erica Aparecida Dos Santos Ribeiro da Silva  1 , Maria Cristina da Silva Lourenço  1 , Beatriz Coelho de Negreiros Nascimento  2 , Valdilea Gonçalves Veloso  1 , Sandra Wagner Cardoso  1 , Cardoso  1 , Cristiane da Cruz Lamas  3
Affiliations

Severe Staphylococcus aureus infection: associated factors and outcomes

Narendra Babu Valobdás et al. Braz J Infect Dis. .

Abstract

Introduction: Staphylococcus aureus causes potentially life-threatening infections, with a somber prognosis when the infection is caused by methicillin-resistant S. aureus due to limited treatment options. The present study describes serious infections by S. aureus in patients hospitalized in an infectious disease's unit in Rio de Janeiro, Brazil, between 2016 and 2021.

Material and methods: This was a retrospective study based on data from positive samples diagnosed by the microbiology laboratory and by review of medical records. Clinical-demographic variables and outcomes were compared between Patients Living with HIV (PLHIV) and non-HIV patients. Data were analyzed using Jamovi 1.6 and R 4.0.1 statistical software.

Results: A total of 67 patients with a serious S. aureus infection were identified, of whom 29 presented bacteremia and 38 other infections. Thirty-one of 67 (46.3%) were PLHIV. The median age of all patients was 46years, although PLHIV were significantly younger than non-HIV individuals (36 vs. 60 years-old, p < 0.001). The median CD4 lymphocyte count was 95 cells/mm3. Community infection occurred in 36/67 (53.7%) patients, of whom 19/36 (52.7%) had bacteremia. A total of 20 MRSA infections (29.9% of the patients) were identified, which accounted for 14/36 (38.8%) of the community infections. More than a third of PLHIV (38.7%) had MRSA, and all these were sensitive to cotrimoxazole. No difference in mortality was found between PLHIV and non-HIV patients, nor between the MRSA and MSSA groups. Bacteremia was present in 29 patients; MRSA accounted for 9 (31.0%) of these. The 30-day mortality was 4/9 (44.4%) and 2/20 (10%) in MRSA and MSSA bacteremia, respectively.

Conclusions: The most frequent comorbidity in patients with severe S. aureus infections was HIV, with a high rate of MRSA infections recorded in PLHIV. PLHIV were younger, but did not suffer higher mortality, although they did have more relapses and new staphylococcal infections.

Keywords: Bacteremia; HIV/AIDS; MRSA; Mortality; Staphylococcus aureus.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest The authors declare no conflicts of interest.

Figures

Fig 1
Fig. 1
Flow chart of the study selection and inclusion process of patients infected with S. aureus based on culture results.
Fig 2
Fig. 2
30-day mortality in patients with S. aureus infection, stratified by MSSA and MRSA infections, and disease presentation. MRSA, Methicillin-Resistant Staphylococcus aureus; MSSA, Methicillin-Sensitive S. Aureus; VAP, Ventilator Associated Pneumonia.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Roberts S., Chambers S. Diagnosis and management of Staphylococcus aureus infections of the skin and soft tissue. Intern Med J. 2005;35(Suppl 2):S97–105. - PubMed
    1. Tong S.Y., Davis J.S., Eichenberger E., Holland T.L., Fowler V.G., Jr Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev. 2015;28:603–661. - PMC - PubMed
    1. Nicolas R., Carricajo A., Morel J., Rigaill J., Grattard F., Guezzou S., et al. Evaluation of effectiveness and compliance with the mupirocin nasal ointment part of Staphylococcus aureus decolonization in real life using UPLC-MS/MS mupirocin quantification. J Antimicrob Chemother. 2020;75:1623–1630. - PubMed
    1. Xie X., Dai X., Ni L., Chen B., Luo Z., Yao Y., et al. Molecular epidemiology and virulence characteristics of Staphylococcus aureus nasal colonization in medical laboratory staff: comparison between microbiological and non-microbiological laboratories. BMC Infect Dis. 2018;18:122. - PMC - PubMed
    1. Hidron A.I., Kourbatova E.V., Halvosa J.S., Terrell B.J., McDougal L.K., Tenover F.C., et al. Risk factors for colonization with methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to an urban hospital: emergence of community-associated MRSA nasal carriage. Clin Infect Dis. 2005;41:159–166. - PubMed