Mortality and hospital stay related to coagulase-negative Staphylococci bacteremia in non-critical patients

• Published in: The Journal of infection 2013-02, Vol.66 (2), p.155-162
• Main Authors: Molina, J, Peñuela, I, Lepe, J.A, Gutiérrez-Pizarraya, A, Gómez, M.J, García-Cabrera, E, Cordero, E, Aznar, J, Pachón, J
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antibiotics; Bacteremia; Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Blood culture; Catheters; Central nervous system; Coagulase - deficiency; Coagulase-negative Staphylococci; Cross Infection; Fever; General aspects; Hospital stay; Hospitals; Human bacterial diseases; Humans; Infectious Disease; Infectious diseases; Length of Stay; Medical sciences; Middle Aged; Morbidity; Mortality; Multivariate analysis; Risk Factors; Sex; Staphylococcal Infections - epidemiology; Staphylococcal Infections - mortality; Staphylococcus - enzymology
• ISSN: 0163-4453; 1532-2742
• DOI: 10.1016/j.jinf.2012.10.021

Summary Objectives To describe the morbidity and mortality related to coagulase-negative Staphylococci (CNS) bacteremia in non-critical patients. Methods Prospective, matched case-control study nested in a cohort. Patients with CNS bacteremia and no other isolate in blood cultures during their admission were defined as cases. Each case was matched by age, sex and area of hospitalization to one control. A 30-day follow-up was performed. Mortality and hospital stay were defined as endpoints. Results 105 cases and 105 controls were included. All cases carried intravascular catheters at the time of inclusion. Cases presented higher mortality compared to controls (14.3% vs. 4.8%), although this association was not independent in a multivariate analysis ( p  = 0.11). CNS bacteremia was independently associated with longer hospital stay (mean 12 vs. 8.5 days, p  = 0.008). Moreover, when patients with CNS bacteremia were specifically analyzed, the persistence of fever ( p  = 0.005) and inappropriate empirical treatment ( p  = 0.04) were independently related to mortality. Conclusion We did not observe increased mortality attributable to CNS bacteremia, although it was associated with longer hospitalizations. Early appropriate empirical antibiotic therapy pending blood culture results might improve the outcome of patients with CNS bacteremia. Close follow-up is recommended if fever persists beyond 72 h.