Staphylococcus aureus bacteraemia in a tropical setting: patient outcome and impact of antibiotic resistance
Background: Most information on invasive <em>Staphylococcus aureus</em> infections comes from temperate countries. There are considerable knowledge gaps in epidemiology, treatment, drug resistance and outcome of invasive <em>S. aureus</em> infection in the tropics. Methods: A...
| Главные авторы: | , , , , , , , , , , , , , , , |
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| Формат: | Journal article |
| Язык: | English |
| Опубликовано: |
Public Library of Science
2009
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| Предметы: |
| _version_ | 1826296180145913856 |
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| author | Nickerson, E Hongsuwan, M Limmathurotsakul, D Wuthiekanun, V Shah, K Srisomang, P Mahavanakul, W Wacharaprechasgul, T Fowler, V West, T Teerawatansauk, N Becher, H White, N Chierakul, W Day, N Peacock, S |
| author_facet | Nickerson, E Hongsuwan, M Limmathurotsakul, D Wuthiekanun, V Shah, K Srisomang, P Mahavanakul, W Wacharaprechasgul, T Fowler, V West, T Teerawatansauk, N Becher, H White, N Chierakul, W Day, N Peacock, S |
| author_sort | Nickerson, E |
| collection | OXFORD |
| description | Background: Most information on invasive <em>Staphylococcus aureus</em> infections comes from temperate countries. There are considerable knowledge gaps in epidemiology, treatment, drug resistance and outcome of invasive <em>S. aureus</em> infection in the tropics. Methods: A prospective, observational study of <em>S. aureus</em> bacteraemia was conducted in a 1000-bed regional hospital in northeast Thailand over 1 year. Detailed clinical data were collected and final outcomes determined at 12 weeks, and correlated with antimicrobial susceptibility profiles of infecting isolates. Principal findings: Ninety-eight patients with <em>S. aureus</em> bacteraemia were recruited. The range of clinical manifestations was similar to that reported from temperate countries. The prevalence of endocarditis was 14%. The disease burden was highest at both extremes of age, whilst mortality increased with age. The all-cause mortality rate was 52%, with a mortality attributable to <em>S. aureus</em> of 44%. Methicillin-resistant <em>S. aureus</em> (MRSA) was responsible for 28% of infections, all of which were healthcare-associated. Mortality rates for MRSA and methicillin-susceptible <em>S. aureus</em> (MSSA) were 67% (18/27) and 46 (33/71), respectively (p=0.11). MRSA isolates were multidrug resistant. Only vancomycin or fusidic acid would be suitable as empirical treatment options for suspected MRSA infection. Conclusions: <em>S. aureus</em> is a significant pathogen in northeast Thailand, with comparable clinical manifestations and a similar endocarditis prevalence but higher mortality than industrialised countries. <em>S. aureus</em> bacteraemia is frequently associated with exposure to healthcare settings with MRSA causing a considerable burden of disease. Further studies are required to define setting-specific strategies to reduce mortality from <em>S. aureus</em> bacteraemia, prevent MRSA transmission, and to define the burden of <em>S. aureus</em> disease and emergence of drug resistance throughout the developing world. |
| first_indexed | 2024-03-07T04:12:24Z |
| format | Journal article |
| id | oxford-uuid:c8454814-411b-4901-8239-f488fa9aa20c |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T04:12:24Z |
| publishDate | 2009 |
| publisher | Public Library of Science |
| record_format | dspace |
| spelling | oxford-uuid:c8454814-411b-4901-8239-f488fa9aa20c2022-03-27T06:51:10ZStaphylococcus aureus bacteraemia in a tropical setting: patient outcome and impact of antibiotic resistanceJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:c8454814-411b-4901-8239-f488fa9aa20cMedical sciencesTropical medicineEpidemiologyEnglishOxford University Research Archive - ValetPublic Library of Science2009Nickerson, EHongsuwan, MLimmathurotsakul, DWuthiekanun, VShah, KSrisomang, PMahavanakul, WWacharaprechasgul, TFowler, VWest, TTeerawatansauk, NBecher, HWhite, NChierakul, WDay, NPeacock, SBackground: Most information on invasive <em>Staphylococcus aureus</em> infections comes from temperate countries. There are considerable knowledge gaps in epidemiology, treatment, drug resistance and outcome of invasive <em>S. aureus</em> infection in the tropics. Methods: A prospective, observational study of <em>S. aureus</em> bacteraemia was conducted in a 1000-bed regional hospital in northeast Thailand over 1 year. Detailed clinical data were collected and final outcomes determined at 12 weeks, and correlated with antimicrobial susceptibility profiles of infecting isolates. Principal findings: Ninety-eight patients with <em>S. aureus</em> bacteraemia were recruited. The range of clinical manifestations was similar to that reported from temperate countries. The prevalence of endocarditis was 14%. The disease burden was highest at both extremes of age, whilst mortality increased with age. The all-cause mortality rate was 52%, with a mortality attributable to <em>S. aureus</em> of 44%. Methicillin-resistant <em>S. aureus</em> (MRSA) was responsible for 28% of infections, all of which were healthcare-associated. Mortality rates for MRSA and methicillin-susceptible <em>S. aureus</em> (MSSA) were 67% (18/27) and 46 (33/71), respectively (p=0.11). MRSA isolates were multidrug resistant. Only vancomycin or fusidic acid would be suitable as empirical treatment options for suspected MRSA infection. Conclusions: <em>S. aureus</em> is a significant pathogen in northeast Thailand, with comparable clinical manifestations and a similar endocarditis prevalence but higher mortality than industrialised countries. <em>S. aureus</em> bacteraemia is frequently associated with exposure to healthcare settings with MRSA causing a considerable burden of disease. Further studies are required to define setting-specific strategies to reduce mortality from <em>S. aureus</em> bacteraemia, prevent MRSA transmission, and to define the burden of <em>S. aureus</em> disease and emergence of drug resistance throughout the developing world. |
| spellingShingle | Medical sciences Tropical medicine Epidemiology Nickerson, E Hongsuwan, M Limmathurotsakul, D Wuthiekanun, V Shah, K Srisomang, P Mahavanakul, W Wacharaprechasgul, T Fowler, V West, T Teerawatansauk, N Becher, H White, N Chierakul, W Day, N Peacock, S Staphylococcus aureus bacteraemia in a tropical setting: patient outcome and impact of antibiotic resistance |
| title | Staphylococcus aureus bacteraemia in a tropical setting: patient outcome and impact of antibiotic resistance |
| title_full | Staphylococcus aureus bacteraemia in a tropical setting: patient outcome and impact of antibiotic resistance |
| title_fullStr | Staphylococcus aureus bacteraemia in a tropical setting: patient outcome and impact of antibiotic resistance |
| title_full_unstemmed | Staphylococcus aureus bacteraemia in a tropical setting: patient outcome and impact of antibiotic resistance |
| title_short | Staphylococcus aureus bacteraemia in a tropical setting: patient outcome and impact of antibiotic resistance |
| title_sort | staphylococcus aureus bacteraemia in a tropical setting patient outcome and impact of antibiotic resistance |
| topic | Medical sciences Tropical medicine Epidemiology |
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