ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2024
The Utility of Risk Factors to Define Complicated Staphylococcus aureus Bacteremia in a Setting With Low Methicillin-Resistant S. aureus Prevalence.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Combination antibiotic therapy in Staphylococcus aureus endocarditis: evidence, controversies, and future directions.Infection · 2026Review
- Oritavancin in Complicated Bloodstream Infections and Endocarditis in Spain and Italy (ORIBAC Study): A Retrospective Multicenter Observational Study.Infectious diseases and therapy · 2026Article
- Methicillin-resistant and susceptible Staphylococcus aureus: tolerance, immune evasion and treatment.Nature reviews. Microbiology · 2026Review
- Predictors of osteo-articular infection inJournal of bone and joint infection · 2026Article
- Predictors of mortality inThe Journal of international medical research · 2025Observational
- Early cytokine signatures and clinical phenotypes discriminate persistent from resolving MRSA bacteremia.BMC infectious diseases · 2025Article
- Association of Daily Body Temperature, White Blood Cell Count, and C-reactive Protein With Mortality and Persistent Bacteremia in Patients WithOpen forum infectious diseases · 2025Article
- Review
- The role of [18F]FDG-PET/CT in Staphylococcus aureus bacteremia: A clinical perspective.Npj imaging · 2024Review
- Article
- Adjunctive β-lactams forTherapeutic advances in infectious diseaseReview
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9 authors.
Funding
Abstract
introductionRecommended duration of antibiotic treatment of Staphylococcus aureus bacteremia (SAB) is frequently based on distinguishing uncomplicated and complicated SAB, and several risk factors at the onset of infection have been proposed to define complicated SAB. Predictive values of risk factors for complicated SAB have not been validated, and consequences of their use on antibiotic prescriptions are unknown.
methodsIn a prospective cohort, patients with SAB were categorized as complicated or uncomplicated through adjudication (reference definition). Associations and predictive values of 9 risk factors were determined, compared with the reference definition, as was accuracy of Infectious Diseases Society of America (IDSA) criteria that include 4 risk factors, and the projected consequences of applying IDSA criteria on antibiotic use.
resultsAmong 490 patients, 296 (60%) had complicated SAB. In multivariable analysis, persistent bacteremia (odds ratio [OR], 6.8; 95% confidence interval [CI], 3.9-12.0), community acquisition of SAB (OR, 2.9; 95% CI, 1.9-4.7) and presence of prosthetic material (OR, 2.3; 95% CI, 1.5-3.6) were associated with complicated SAB. Presence of any of the 4 risk factors in the IDSA definition of complicated SAB had a positive predictive value of 70.9% (95% CI, 65.5-75.9) and a negative predictive value of 57.5% (95% CI, 49.1-64.8). Compared with the reference, IDSA criteria yielded 24 (5%) false-negative and 90 (18%) false-positive classifications of complicated SAB. Median duration of antibiotic treatment of these 90 patients was 16 days (interquartile range, 14-19), all with favorable clinical outcome.
conclusionsRisk factors have low to moderate predictive value to identify complicated SAB and their use may lead to unnecessary prolonged antibiotic use.
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