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. 2025 Aug 21;15(1):30709.
doi: 10.1038/s41598-025-16137-8.

Clinical and laboratory predictors of mortality in Staphylococcus aureus bacteremia

Deniz Borcak  1 , Yusuf Emre Ozdemir  2 , Zuhal Yesilbag  3 , Samiha Akkaya  2 , Esra Ensaroglu  2 , Aysegul Inci Sezen  2 , Esra Canbolat Unlu  2 , Fatma Bayrak Erdem  2 , Sevtap Senoglu  2 , Zeynep Cizmeci  4 , Hayat Kumbasar Karaosmanoglu  3 , Kadriye Kart Yasar  2
Affiliations

Clinical and laboratory predictors of mortality in Staphylococcus aureus bacteremia

Deniz Borcak et al. Sci Rep. .

Abstract

This study aimed to describe the epidemiological and clinical features of patients admitted to non-intensive care hospital wards due to Staphylococcus aureus bacteremia (SAB) and to identify predictors of mortality to improve patient outcomes. This single-center retrospective study included hospitalized patients with SAB between 2016 and 2024. We retrieved clinical and microbiological data retrospectively from the electronic medical record system. The research comprised 356 patients with SAB. The 30-day and in-hospital mortality rates were 7.3% (n = 26) and 9.8% (n = 35), respectively. The multivariate analysis revealed neutrophil-to-lymphocyte ratio (NLR) (HR = 1.08; 95% CI = 1.02-1.13; p = 0.002), CRP (HR = 1.01; 95% CI = 1-1.02 ; p = 0.04), and albumin (HR = 0.83; 95% CI = 0.73-0.95; p = 0.008) as predictors for 30-day mortality. Pneumonia (HR = 15.03; 95% CI = 2.05-109.71; p = 0.008), leukemia (HR = 28.72; 95% CI = 1.56-525.92; p = 0.002), and sepsis (HR = 7.06; 95% CI = 1.02-48.53; p = 0.002) were identified as significant risk factors for mortality. Using the Cox regression analysis, age (HR: 1.05, CI:1.01-1.10, p = 0.01), leukemia (HR: 0.80, CI:0.71-0.90, p < 0.001), and low albumin level (HR: 11.76; CI:1.76-78.42, p = 0.01) were identified as independent risk factors affecting in-hospital mortality. We used the receiver operating characteristic (ROC) curve to predict the30-day mortality. The area under the ROC curve values were 0.619 (p = 0.044) for NLR, 0.692 (p = 0.001) for CRP, and 0.791 (p < 0.001) for albumin. The highest sensitivity and specificity at 30-day mortality were obtained from CRP and albumin, with a sensitivity of 65.4% and a specificity of 78.5% for albumin. Elevated NLR and CRP levels, along with decreased albumin levels, may predict poor clinical outcomes and could assist clinicians in optimizing the management of this bacterial infection. As a result, early diagnosis and appropriate antibiotic treatments are crucial in reducing mortality in SAB.

Keywords: Staphylococcus aureus; Bacteremia; Charlson comorbidity index; Methicillin-resistance; Mortality; Risk factors.

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Conflict of interest statement

Competing interests: The authors declare no competing interests. Human ethics and consent to participate: not applicable. ‘Due to the retrospective nature of the study, waived the need of obtaining informed consent. Ethics approval: This study was approved by the University of Health Sciences, Turkey, Bakırköy Dr. Sadi Konuk Training and Research Hospital Clinical Research Ethics Committee (approval number: 2023-08-15, date:17.04.2023). This study complied with the Declaration of Helsinki.

Figures

Fig. 1
Fig. 1
Receiver operating characteristic curves of laboratory parameters for 30-day mortality.
See this image and copyright information in PMC

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