Staphylococcus aureus bacteremia in patients with Hickman catheters

purpose: Determination of outcome and prognostic variables associated with Staphylococcus aureus bacteremia in patients with Hickman catheters. patients and methods: At the University of Washington Medical Center, 37 patients with Hickman catheters and S. aureus bacteremia were studied by retrospective chart review. Clinical features associated with each episode of infection were determined, and the relationships among clinical features, therapy, and outcomes were explored. results: Only 18% of all Hickman catheter-associated S. aureus bacteremias and only 10% of those cases with exit site infections were cured without catheter removal. In seven of41 episodes (17%), death or bacteremic relapse occurred. The best prognosis was found in infections with a low blood culture colony count (less than 1 colony/mL). conclusion: Hickman catheter-associated bacteremia due to S. aureus has a worse prognosis than other Hickman catheter-associated bacteremias. Early catheter removal should be considered except in cases with a remote, noncatheter focus of infection or in infections with no catheter-related physical signs and blood culture colony counts of less than 1/mL.