Volume 22, Number 6—June 2016
Research
High MICs for Vancomycin and Daptomycin and Complicated Catheter-Related Bloodstream Infections with Methicillin-Sensitive Staphylococcus aureus
Rafael San-Juan
, Esther Viedma, Fernando Chaves, Antonio Lalueza, Jesús Fortún, Elena Loza, Miquel Pujol, Carmen Ardanuy, Isabel Morales, Marina de Cueto, Elena Resino-Foz, Alejandra Morales-Cartagena, Alicia Rico, María P. Romero, María Ángeles Orellana, Francisco López-Medrano, Mario Fernández-Ruiz, and José María Aguado
, Esther Viedma, Fernando Chaves, Antonio Lalueza, Jesús Fortún, Elena Loza, Miquel Pujol, Carmen Ardanuy, Isabel Morales, Marina de Cueto, Elena Resino-Foz, Alejandra Morales-Cartagena, Alicia Rico, María P. Romero, María Ángeles Orellana, Francisco López-Medrano, Mario Fernández-Ruiz, and José María Aguado
Table 1
Demographics and clinical characteristics of 83 patients with methicillin-sensitive Staphylococcus aureus catheter-related bloodstream infection*
| Variable | Value |
|---|---|
| Age, y | 60 ± 1.9 |
| Male sex |
49 (59.0) |
| Recruiting center | |
| 1 | 32 (38.6) |
| 2 | 19 (22.9) |
| 3 | 2 (2.4) |
| 4 | 12 (14.5) |
| 5 |
18 (21.7) |
| Prognosis of underlying disease | |
| Not fatal | 31 (37.3) |
| Fatal | 44 (53.0) |
| Rapidly fatal |
8 (9.6) |
| Charlson comorbidity index |
3.7 ± 2.3 |
| Previous conditions | |
| Diabetes | 32 (38.6) |
| Malignancy | 45 (54.2) |
| Valvular prosthesis | 1 (1.2) |
| Ostheoarticular prosthesis | 3 (3.6) |
| Renal failure requiring hemodialysis |
10 (12) |
| Type of intravascular catheter | |
| Peripheral venous | 32 (38.6) |
| Nontunneled (temporary) central venous | 25 (30.1) |
| Peripherally inserted central | 10 (12) |
| Permanent central venous |
16 (19.3) |
| Pitt score at bacteremia onset | 1.6 ± 1.4 |
| Severe sepsis or septic shock |
17 (20.5) |
| Empiric treatment including† | |
| Glycopeptides | 32 (38.5) |
| Antistaphylococcal β-lactams‡ | 43 (51.8) |
| Other antistaphylococcal antimicrobial drugs | 4 (4.8) |
| Daptomycin | 17 (20.4) |
| None or noneffective antimicrobial drugs |
12 (14.5) |
| Antimicrobial regimen | |
| Glycopeptides followed by antistaphylococcal β-lactam | 25 (30.1) |
| Only antistaphylococcal β-lactams | 30 (36.1) |
| Daptomycin followed by antistaphylococcal β-lactam | 12 (14.5) |
| Only daptomycin | 1 (1.2) |
| Glycopeptides followed by daptomycin plus antistaphylococcal β-lactam | 7 (8.4) |
| Daptomycin plus antistaphylococcal β-lactam | 7 (8.4) |
| Other |
1 (1.2) |
| Timing of catheter removal | |
| Same day or before sampling first blood cultures | 47 (56.6) |
| 1 day after sampling | 12 (14.5) |
| 2 days after sampling | 17 (20.5) |
| 3 days after sampling |
7 (8.4) |
| Venous Doppler ultrasound examination | 41 (49.5) |
| Echocardiogram |
61 (73.5) |
| Complicated MSSA CRBSI | 26 (31.3) |
| Persistent fever >4 d§ | 11 (13.3) |
| Persistent bacteremia >72 h¶ | 6 (7.2) |
| Septic thrombophlebitis | 10 (12) |
| Endocarditis | 2 (2.4) |
| Hematogenous osteoarticular infection | 2 (2.4) |
| Pulmonary emboli |
2 (2.4) |
| All-cause deaths at 30 days | 10 (12) |
| MSSA CRBSI−attributable deaths at 30 days | 2 (2.4) |
*Values are mean ± SD or no. (%). MSSA CRBSI: methicillin-sensitive S. aureus catheter-related bloodstream infection.
†Some patients could be included in >1 category.
‡Parenteral cloxacillin, cefazolin, amoxicillin/clavulanate, piperacillin/tazobactam, imipenem, or meropenem.
§Coincident with other forms of complicated bacteremia for 5 cases.
¶Coincident with other forms of complicated bacteremia in 5 cases.
Page created: May 16, 2016
Page updated: May 16, 2016
Page reviewed: May 16, 2016
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