Validation of a new risk stratification system-based management for methicillin-resistant Staphylococcus aureus bacteraemia: analysis of a multicentre prospective study
DC Field | Value | Language |
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dc.contributor.author | Kim, Taeeun | - |
dc.contributor.author | Lee, Sang-Rok | - |
dc.contributor.author | Park, Seong Yeon | - |
dc.contributor.author | Moon, Song Mi | - |
dc.contributor.author | Jung, Jiwon | - |
dc.contributor.author | Kim, Min Jae | - |
dc.contributor.author | Sung, Heungsup | - |
dc.contributor.author | Kim, Mi-Na | - |
dc.contributor.author | Kim, Sung-Han | - |
dc.contributor.author | Choi, Sang-Ho | - |
dc.contributor.author | Lee, Sang-Oh | - |
dc.contributor.author | Kim, Yang Soo | - |
dc.contributor.author | Song, Eun Hee | - |
dc.contributor.author | Chong, Yong Pil | - |
dc.date.accessioned | 2024-06-06T09:00:18Z | - |
dc.date.available | 2024-06-06T09:00:18Z | - |
dc.date.issued | 2024-05 | - |
dc.identifier.issn | 0934-9723 | - |
dc.identifier.issn | 1435-4373 | - |
dc.identifier.uri | https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/91452 | - |
dc.description.abstract | Purpose Distinguishing between complicated and uncomplicated Staphylococcus aureus bacteraemia (SAB) is therapeutically essential. However, this distinction has limitations in reflecting the heterogeneity of SAB and encouraging targeted diagnostics. Recently, a new risk stratification system for SAB metastatic infection, involving stepwise approaches to diagnosis and treatment, has been suggested. We assessed its applicability in methicillin-resistant SAB (MRSAB) patients. Methods We retrospectively analysed data of a 3-year multicentre, prospective cohort of hospitalised patients with MRSAB. We classified the patients into three risk groups: low, indeterminate, and high, based on the new system and compared between-group management and outcomes. Results Of 380 patients with MRSAB, 6.3% were classified as low-, 7.6% as indeterminate-, and 86.1% as high-risk for metastatic infection. No metastatic infection occurred in the low-, 6.9% in the indeterminate-, and 19.6% in the high-risk groups (P < 0.001). After an in-depth diagnostic work-up, patients were finally diagnosed as 'without metastatic infection (6.3%)', 'with metastatic infection (17.4%)', and 'uncertain for metastatic infection (76.3%)'. 30-day mortality increased as the severity of diagnosis shifted from 'without metastatic infection' to 'uncertain for metastatic infection' and 'with metastatic infection' (P = 0.09). In multivariable analysis, independent factors associated with metastatic complications were suspicion of endocarditis in transthoracic echocardiography, clinical signs of metastatic infection, Pitt bacteraemia score >= 4, and persistent bacteraemia. Conclusions The new risk stratification system shows promise in predicting metastatic complications and guiding work-up and management of MRSAB. However, reducing the number of cases labelled as 'high-risk' and 'uncertain for metastatic infection' remains an area for improvement. | - |
dc.format.extent | 11 | - |
dc.language | 영어 | - |
dc.language.iso | ENG | - |
dc.publisher | SPRINGER | - |
dc.title | Validation of a new risk stratification system-based management for methicillin-resistant Staphylococcus aureus bacteraemia: analysis of a multicentre prospective study | - |
dc.type | Article | - |
dc.identifier.wosid | 001173680000001 | - |
dc.identifier.doi | 10.1007/s10096-024-04790-2 | - |
dc.identifier.bibliographicCitation | EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, v.43, no.5, pp 841 - 851 | - |
dc.description.isOpenAccess | N | - |
dc.identifier.scopusid | 2-s2.0-85186201929 | - |
dc.citation.endPage | 851 | - |
dc.citation.startPage | 841 | - |
dc.citation.title | EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES | - |
dc.citation.volume | 43 | - |
dc.citation.number | 5 | - |
dc.type.docType | Article | - |
dc.publisher.location | 미국 | - |
dc.subject.keywordAuthor | Staphylococcus aureus bacteraemia | - |
dc.subject.keywordAuthor | Methicillin-resistance | - |
dc.subject.keywordAuthor | Complicated bacteraemia | - |
dc.subject.keywordAuthor | Metastatic infection | - |
dc.subject.keywordAuthor | Risk stratification | - |
dc.subject.keywordPlus | INFECTIONS | - |
dc.subject.keywordPlus | CRITERIA | - |
dc.subject.keywordPlus | OUTCOMES | - |
dc.subject.keywordPlus | ADULTS | - |
dc.relation.journalResearchArea | Infectious Diseases | - |
dc.relation.journalResearchArea | Microbiology | - |
dc.relation.journalWebOfScienceCategory | Infectious Diseases | - |
dc.relation.journalWebOfScienceCategory | Microbiology | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
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