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Table 3 Predictors of 28-day All-Cause Mortality after Diagnosis of Methicillin-Resistant Staphylococcus aureus Bacteremia for 163 Patients

From: The impact of vancomycin susceptibility on treatment outcomes among patients with methicillin resistant Staphylococcus aureusbacteremia

Variable

Death

(n = 35)

Alive

(n = 128)

Crude HR

(95% CI)

Adjusted HR

(95% CI)

Age, years, median (range)

64 (33-92)

56 (23-95)

1.03 (1.00-1.05)

1.03 (1.00-1.05)

Female gender

16 (45.7)

67 (52.3)

0.83 (0.43-1.61)

 

White race

20 (57.1)

70 (54.7)

1.05 (0.54-2.05)

 

Congestive heart failure

9 (25.7)

26 (20.3)

1.33 (0.62-2.84)

 

Coronary artery disease

8 (22.9)

29 (22.7)

0.99 (0.45-2.19)

 

Chronic obstructive pulmonary diseases

10 (28.6)

27 (21.1)

1.43 (0.69-2.97)

 

Renal function

    

   Normal

25 (71.4)

92 (71.9)

Reference

 

   CRI without dialysis

7 (20.0)

7 (5.5)

2.67 (1.15-6.17)

 

   CRI with dialysis

3 (8.6)

29 (22.7)

0.42 (0.13-1.37)

 

Malignancy

8 (22.9)

27 (21.1)

1.08 (0.49-2.37)

 

HIV infection

1 (2.9)

6 (4.7)

0.58 (0.08-4.26)

 

Chronic skin disease

2 (5.7)

11 (8.6)

0.69 (0.17-2.87)

 

Peripheral vascular diseases

2 (5.7)

9 (7.0)

0.81 (0.19-3.37)

 

Diabetes mellitus

10 (28.6)

51 (39.8)

0.64 (0.31-1.32)

 

Systemic corticosteroid use last 28 days

8 (22.9)

16 (12.5)

2.01 (0.91-4.42)

 

Cirrhosis

6 (17.1)

8 (6.3)

2.50 (1.04-6.02)

3.01 (1.24-7.30)

History of intravenous drug use

2 (5.7)

13 (10.2)

0.57 (0.14-2.37)

 

History of smoking

22 (62.9)

73 (57.0)

1.27 (0.64-2.52)

 

Alcohol use

11 (31.4)

39 (30.5)

1.06 (0.52-2.15)

 

Any transplant

2 (5.7)

8 (6.3)

0.89 (0.22-3.73)

 

Surgery during hospitalization

4 (11.4)

19 (14.8)

0.78 (0.28-2.21)

 

Prosthetic joint

0

15 (11.7)

0.04 (0-5.06)

 

Vascular graft

1 (2.9)

22 (17.2)

0.16 (0.02-1.16)

 

Cardiac device

3 (8.6)

7 (5.5)

1.40 (0.43-4.56)

 

ICU admission within 48 hours after the first positive blood culture

25 (71.4)

34 (26.6)

5.56 (2.67-11.60)

5.99 (2.86-12.58)

Central venous catheterization at the time of the first positive blood culture

29 (82.9)

85 (66.4)

2.25 (0.93-5.42)

 

Onset

    

   Community-associated

3 (8.6)

9 (7.0)

Reference

 

   Healthcare-associated community onset

21 (60.0)

77 (60.2)

0.76 (0.23-2.55)

 

   Healthcare-associated hospital onset

11 (31.4)

42 (32.8)

0.75 (0.21-2.67)

 

Any metastatic infection at the time of diagnosis

6 (17.1)

17 (13.3)

1.27 (0.53-3.05)

 

Vancomycin tolerance (n = 162) a, b

1/35 (2.9)

6/127 (4.7)

0.62 (0.08-4.50)

 

Vancomycin initial trough < 15 mg/L

(n = 151)c

14/27 (51.9)

73/124 (58.9)

0.77 (0.36-1.63)

 

Vancomycin MIC ≥ 2 ug/mL

26 (74.3)

86 (67.2)

1.36 (0.64-2.89)

1.57 (0.73-3.37)

  1. CRI, chronic renal insufficiency; HIV, human immunodeficiency virus; ICU, intensive care unit;
  2. MRSA, methicillin-resistant S. aureus; HR, hazard ratio; MIC, minimum inhibitory concentration.
  3. Variables considered but not retained in the final model were renal function (chronic renal failure without dialysis), vascular graft, central venous catheterization at the time of diagnosis, and vancomycin MIC ≥2 ug/mL.
  4. a. See methods for definition.
  5. b. One patient was excluded since MBC: MIC ratio was undetermined.
  6. c. Twelve patients did not have an initial vancomycin trough level. [unknown reason (n = 7) or died before initial trough was obtained (n = 5)]
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BMC Infectious Diseases

ISSN: 1471-2334

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