Clinical characteristics, management practices, and antimicrobial resistance of Staphylococcus aureus bacteremia: A retrospective single-center study

Abstract

AIM: Staphylococcus aureus bacteremia (SAB) remains as a major cause of mortality and antimicrobial resistance (AMR) worldwide. This study aimed to evaluate the clinical characteristics, management, and AMR rates of SAB. METHODS: In this retrospective single-center study, adult patients hospitalized for SAB between 2018 and 2021 were evaluated. Demographic data, clinical and laboratory findings, antimicrobial susceptibility results, and mortality rates were obtained from medical records. A minimum evaluation bundle for managing of SAB was defined as full adherence to infectious diseases (ID) consultation, echocardiography and follow-up cultures. RESULTS: A total of 260 patients with SAB were included, with a median age of 67 (IQR:57-80) years. Comorbidities were present in 95.4%. Primary SAB was identified in 45.8% of cases, with central line (24.6%) being the most common focus. Methicillin-resistant S. aureus (MRSA) accounted for 17.3% of cases, with over 30% resistance to erythromycin, clindamycin, and tetracycline in MRSA isolates. The overall mortality rate was 33.8%. Advanced age (OR: 1.027, p=0.018), malignancy (OR: 3.057, p=0.011), and intensive care unit (ICU) admission (OR: 17.095, p<0.001) were independent risk factors for mortality. A minimum evaluation bundle was performed in only 38.5% of patients; ID consultation (69.2%), follow-up cultures (79.6%), and echocardiography (45.8%). CONCLUSIONS: Based on the study results, SAB caused high mortality, particularly among elderly patients, those with malignancies, and requiring ICU. Adherence to a minimum evaluation bundle was achieved in only one third of the patients. These findings highlight the need for improved management strategies to enhance outcomes in SAB patients.

Keywords

• Staphylococcus aureus
• bacteremia
• management
• antimicrobial resistance