The management of Staphylococcus aureus bacteremia in the United Kingdom and Vietnam: a multi-centre evaluation
Staphylococcus aureus bacteremia is a common and serious infection worldwide and although treatment guidelines exist, there is little consensus on optimal management. In this study we assessed the variation in management and adherence to treatment guidelines of S. aureus bacteremia. We prospectively...
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| description | Staphylococcus aureus bacteremia is a common and serious infection worldwide and although treatment guidelines exist, there is little consensus on optimal management. In this study we assessed the variation in management and adherence to treatment guidelines of S. aureus bacteremia.
We prospectively recorded baseline clinical characteristics, management, and in-hospital outcome of all adults with S. aureus bacteremia treated consecutively over one year in eight centres in the United Kingdom, three in Vietnam and one in Nepal. 630 adults were treated for S. aureus bacteremia: 549 in the UK (21% methicillin-resistant), 80 in Vietnam (19% methicillin-resistant) and 1 in Nepal. In the UK, 41% had a removable infection focus (50% intravenous catheter-related), compared to 12% in Vietnam. Significantly (p50% of treatment with oral antibiotics alone (25% versus 4%). UK centres varied significantly (p50% of treatment (range 12-40%), in those treated for longer than 28 days (range 13-54%), and in those given combination therapy (range 14-94%). 24% died during admission: older age, time in hospital before bacteremia, and an unidentified infection focus were independent predictors of in-hospital death (p |
| doi_str_mv | 10.1371/journal.pone.0014170 |
| format | Article |
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We prospectively recorded baseline clinical characteristics, management, and in-hospital outcome of all adults with S. aureus bacteremia treated consecutively over one year in eight centres in the United Kingdom, three in Vietnam and one in Nepal. 630 adults were treated for S. aureus bacteremia: 549 in the UK (21% methicillin-resistant), 80 in Vietnam (19% methicillin-resistant) and 1 in Nepal. In the UK, 41% had a removable infection focus (50% intravenous catheter-related), compared to 12% in Vietnam. Significantly (p<0.001) higher proportions of UK than Vietnamese patients had an echocardiogram (50% versus 28%), received more than 14 days antibiotic therapy (84% versus 44%), and received >50% of treatment with oral antibiotics alone (25% versus 4%). UK centres varied significantly (p<0.01) in the proportions given oral treatment alone for >50% of treatment (range 12-40%), in those treated for longer than 28 days (range 13-54%), and in those given combination therapy (range 14-94%). 24% died during admission: older age, time in hospital before bacteremia, and an unidentified infection focus were independent predictors of in-hospital death (p<0.001).
The management of S. aureus bacteremia varies widely between the UK and Vietnam and between centres in the UK with little adherence to published guidelines. Controlled trials defining optimal therapy are urgently required.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0014170</identifier><identifier>PMID: 21179193</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Adults ; Age Factors ; Aged ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Bacteremia ; Bacteremia - drug therapy ; Bacteremia - microbiology ; Care and treatment ; Clinical trials ; Drug resistance ; Echocardiography ; Echocardiography - methods ; Female ; Guidelines ; Health aspects ; Humans ; Infection ; Infections ; Infectious Diseases/Antimicrobials and Drug Resistance ; Infectious Diseases/Nosocomial and Healthcare-Associated Infections ; Intravenous administration ; Male ; Management ; Medical instruments ; Methicillin ; Middle Aged ; Mortality ; Nepal ; Nosocomial infections ; Penicillin ; Public Health and Epidemiology/Nosocomial and Healthcare-Associated Infections ; Staphylococcal Infections - drug therapy ; Staphylococcus aureus ; Staphylococcus aureus - metabolism ; Staphylococcus infections ; Therapy ; United Kingdom ; Vietnam</subject><ispartof>PloS one, 2010-12, Vol.5 (12), p.e14170-e14170</ispartof><rights>COPYRIGHT 2010 Public Library of Science</rights><rights>2010 Thwaites, United Kingdom Clinical Infection Research Group (UKCIRG). This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Thwaites, United Kingdom Clinical Infection Research Group (UKCIRG). 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c691t-f266d70b1919306b38571c2056b21e4608d3d0fdf7988ed1abc1616ef9336bc3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3001442/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3001442/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21179193$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thwaites, Guy E</creatorcontrib><creatorcontrib>United Kingdom Clinical Infection Research Group (UKCIRG)</creatorcontrib><title>The management of Staphylococcus aureus bacteremia in the United Kingdom and Vietnam: a multi-centre evaluation</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Staphylococcus aureus bacteremia is a common and serious infection worldwide and although treatment guidelines exist, there is little consensus on optimal management. In this study we assessed the variation in management and adherence to treatment guidelines of S. aureus bacteremia.
We prospectively recorded baseline clinical characteristics, management, and in-hospital outcome of all adults with S. aureus bacteremia treated consecutively over one year in eight centres in the United Kingdom, three in Vietnam and one in Nepal. 630 adults were treated for S. aureus bacteremia: 549 in the UK (21% methicillin-resistant), 80 in Vietnam (19% methicillin-resistant) and 1 in Nepal. In the UK, 41% had a removable infection focus (50% intravenous catheter-related), compared to 12% in Vietnam. Significantly (p<0.001) higher proportions of UK than Vietnamese patients had an echocardiogram (50% versus 28%), received more than 14 days antibiotic therapy (84% versus 44%), and received >50% of treatment with oral antibiotics alone (25% versus 4%). UK centres varied significantly (p<0.01) in the proportions given oral treatment alone for >50% of treatment (range 12-40%), in those treated for longer than 28 days (range 13-54%), and in those given combination therapy (range 14-94%). 24% died during admission: older age, time in hospital before bacteremia, and an unidentified infection focus were independent predictors of in-hospital death (p<0.001).
The management of S. aureus bacteremia varies widely between the UK and Vietnam and between centres in the UK with little adherence to published guidelines. Controlled trials defining optimal therapy are urgently required.</description><subject>Adult</subject><subject>Adults</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Bacteremia</subject><subject>Bacteremia - drug therapy</subject><subject>Bacteremia - microbiology</subject><subject>Care and treatment</subject><subject>Clinical trials</subject><subject>Drug resistance</subject><subject>Echocardiography</subject><subject>Echocardiography - methods</subject><subject>Female</subject><subject>Guidelines</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Infection</subject><subject>Infections</subject><subject>Infectious Diseases/Antimicrobials and Drug Resistance</subject><subject>Infectious Diseases/Nosocomial and Healthcare-Associated Infections</subject><subject>Intravenous administration</subject><subject>Male</subject><subject>Management</subject><subject>Medical instruments</subject><subject>Methicillin</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nepal</subject><subject>Nosocomial infections</subject><subject>Penicillin</subject><subject>Public Health and Epidemiology/Nosocomial and Healthcare-Associated Infections</subject><subject>Staphylococcal Infections - drug therapy</subject><subject>Staphylococcus aureus</subject><subject>Staphylococcus aureus - metabolism</subject><subject>Staphylococcus infections</subject><subject>Therapy</subject><subject>United Kingdom</subject><subject>Vietnam</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk01v1DAQhiMEoqXwDxBYQgJx2MWOEyfhgFRVfKyoVIkuvVoTZ5J1ldjb2Knov8fZTasN6gH5YMt-3nfsGU8UvWZ0yXjGPl3boTfQLrfW4JJSlrCMPomOWcHjhYgpf3qwPopeOHdNacpzIZ5HRzFjWRFOjyO73iDpwECDHRpPbE0uPWw3d61VVqnBERh6DFMJymOPnQaiDfFB9dtojxX5qU1T2Y6AqciVRm-g-0yAdEPr9UIFzx4J3kI7gNfWvIye1dA6fDXNJ9H629f12Y_F-cX31dnp-UKJgvlFHQtRZbRk4y2pKHmeZkzFNBVlzDARNK94Reuqzoo8x4pBqZhgAuuCc1EqfhK93dtuW-vklConGWd5wbMsZ4FY7YnKwrXc9rqD_k5a0HK3YftGQu-1alGmNKvLGlCUgiZlrgAZh5gXKatykddp8PoyRRvKDqvdo6Gdmc5PjN7Ixt5KPtYtiYPBh8mgtzcDOi877RS2LRi0g5N5KFiRxjvy3T_k44-bqAbC_bWpbQirRk95mmQ8Z5mgRaCWj1BhVKHMKnyrWof9meDjTBAYj398A4NzcnX56__Zi6s5-_6A3SC0fuNsO4wfxs3BZA-q3jrXY_2QY0bl2BX32ZBjV8ipK4LszWF9HkT3bcD_AoLeB5c</recordid><startdate>20101213</startdate><enddate>20101213</enddate><creator>Thwaites, Guy E</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20101213</creationdate><title>The management of Staphylococcus aureus bacteremia in the United Kingdom and Vietnam: a multi-centre evaluation</title><author>Thwaites, Guy E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c691t-f266d70b1919306b38571c2056b21e4608d3d0fdf7988ed1abc1616ef9336bc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Adults</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Anti-Bacterial Agents - 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drug therapy</topic><topic>Staphylococcus aureus</topic><topic>Staphylococcus aureus - metabolism</topic><topic>Staphylococcus infections</topic><topic>Therapy</topic><topic>United Kingdom</topic><topic>Vietnam</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thwaites, Guy E</creatorcontrib><creatorcontrib>United Kingdom Clinical Infection Research Group (UKCIRG)</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thwaites, Guy E</au><aucorp>United Kingdom Clinical Infection Research Group (UKCIRG)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The management of Staphylococcus aureus bacteremia in the United Kingdom and Vietnam: a multi-centre evaluation</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2010-12-13</date><risdate>2010</risdate><volume>5</volume><issue>12</issue><spage>e14170</spage><epage>e14170</epage><pages>e14170-e14170</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Staphylococcus aureus bacteremia is a common and serious infection worldwide and although treatment guidelines exist, there is little consensus on optimal management. In this study we assessed the variation in management and adherence to treatment guidelines of S. aureus bacteremia.
We prospectively recorded baseline clinical characteristics, management, and in-hospital outcome of all adults with S. aureus bacteremia treated consecutively over one year in eight centres in the United Kingdom, three in Vietnam and one in Nepal. 630 adults were treated for S. aureus bacteremia: 549 in the UK (21% methicillin-resistant), 80 in Vietnam (19% methicillin-resistant) and 1 in Nepal. In the UK, 41% had a removable infection focus (50% intravenous catheter-related), compared to 12% in Vietnam. Significantly (p<0.001) higher proportions of UK than Vietnamese patients had an echocardiogram (50% versus 28%), received more than 14 days antibiotic therapy (84% versus 44%), and received >50% of treatment with oral antibiotics alone (25% versus 4%). UK centres varied significantly (p<0.01) in the proportions given oral treatment alone for >50% of treatment (range 12-40%), in those treated for longer than 28 days (range 13-54%), and in those given combination therapy (range 14-94%). 24% died during admission: older age, time in hospital before bacteremia, and an unidentified infection focus were independent predictors of in-hospital death (p<0.001).
The management of S. aureus bacteremia varies widely between the UK and Vietnam and between centres in the UK with little adherence to published guidelines. Controlled trials defining optimal therapy are urgently required.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>21179193</pmid><doi>10.1371/journal.pone.0014170</doi><tpages>e14170</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adult Adults Age Factors Aged Anti-Bacterial Agents - therapeutic use Antibiotics Bacteremia Bacteremia - drug therapy Bacteremia - microbiology Care and treatment Clinical trials Drug resistance Echocardiography Echocardiography - methods Female Guidelines Health aspects Humans Infection Infections Infectious Diseases/Antimicrobials and Drug Resistance Infectious Diseases/Nosocomial and Healthcare-Associated Infections Intravenous administration Male Management Medical instruments Methicillin Middle Aged Mortality Nepal Nosocomial infections Penicillin Public Health and Epidemiology/Nosocomial and Healthcare-Associated Infections Staphylococcal Infections - drug therapy Staphylococcus aureus Staphylococcus aureus - metabolism Staphylococcus infections Therapy United Kingdom Vietnam |
| title | The management of Staphylococcus aureus bacteremia in the United Kingdom and Vietnam: a multi-centre evaluation |
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