Download PDF
CC BY-NC-ND 4.0 · J Lab Physicians 2013; 5(01): 46-50
DOI: 10.4103/0974-2727.115939
Original Article

Staphylococcal Blood Stream Infections: Epidemiology, Resistance Pattern and Outcome at a Level 1 Indian Trauma Care Center

Vibhor Tak
Department of Laboratory Medicine, JPNA Trauma Centre, AIIMS, New Delhi, India
,
Purva Mathur
Department of Laboratory Medicine, JPNA Trauma Centre, AIIMS, New Delhi, India
,
Sanjeev Lalwani
Department of Forensic Medicine, JPNA Trauma Centre, AIIMS, New Delhi, India
,
Mahesh Chandra Misra
Department of Surgery JPNA Trauma Centre, AIIMS, New Delhi, India
› Author Affiliations Source of Support: Nil
› Further Information
Also available at
  PDF Download Permissions and Reprints

ABSTRACT

Purpose: Blood stream infection (BSI)/bacteremia is a potentially life threatening infection and are associated with a high crude mortality. Coagulase negative Staphylococcus (CONS) and Staphylococcus aureus are the most commonly isolated gram positive bacteria from blood culture samples. While S. aureus is a known pathogen causing BSIs, CONS are considered to be common contaminants of blood culture. Of late many studies have challenged this traditional viewpoint. The aim of this study was to determine the epidemiology and significance of Staphylococcus aureus and CONS bacteremia, their resistance patterns and associated mortality in critically ill trauma patients admitted to a level 1 trauma center.

Materials and Methods: The study was conducted from January 2009 to June 2011. All patients from whose blood samples yielded a S. aureus or CONS on culture were included in this study. A detailed history was obtained and follow-up of the patients was done. The isolates of Staphylococci were identified to species level. Antibiotic susceptibility was performed by the disc diffusion method and VITEK-2 system.

Results: During this 30 month period, total of 10,509 blood samples were received from 2,938 patients. A total of 1,961 samples taken from 905 patients were positive for one or more pathogens. S. aureus/CONS were isolated from 469 samples from 374 patients. Crude mortality amongst the patients having Staphylococcal BSI was 25% (94/374).

Conclusion: Staphylococcal blood stream infections are a leading cause of morbidity and mortality.

Key words:

Bacteremia - coagulase negative staphylococcus - methicillin resistant Staphylococcus aureus - mortality - Staphylococcus aureus


Publication History

Article published online:
07 April 2020

© 2013.

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • REFERENCES

  • 1 Pittet D, Li N, Woolson F, Wenzel RP. Microbiological factors influencing the outcome of nosocomial bloodstream infections: A 6-year validated population based model. Clin Infect Dis 1997;24:1068-78.
  • 2 Parameswaran R, Sherchan JB, Varma DM, Mukhopadhyay C, Vidyasagar S. Intravascular catheter-related infections in an Indian tertiary care hospital. J Infect Dev Ctries 2011;5:452-8.
  • 3 Edmond MB, Wallace SE, McClish DK, Pfaller MA, Jones RN, Wenzel RP. Nosocomial bloodstream infections in United States hospitals: A three-year analysis. Clin Infect Dis 1999;29:239-44.
  • 4 Steinberg JP, Clark CC, Hackman BO. Nosocomial and community-acquired Staphylococcus aureus bacteremias from 1980 to 1993: Impact of intravascular devices and methicillin resistance. Clin Infect Dis 1996;23:255-9.
  • 5 Forsblom E, Ruotsalaenin E, Molkanen T, Olgren J, Lyttikainen O, Jarvinen A. Predisposing factors, disease progression and outcome in 430 prospectively followed patients of healthcare- and community-associated Staphylococcus aureus bacteremia. J Hosp Infect 2011;78:102-7.
  • 6 Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36:309-32.
  • 7 CLSI. Clinical and Laboratory Standards Institute. Performance standards for Antimicrobial Disk Susceptibility Tests; Approved Standard- Tenth Edition. CLSI Document M02-A10. Wayne, Pennysylavania, USA: CLSI; 2009.
  • 8 CLSI. Clinical and Laboratory Standards Institute. Performance standards for Antimicrobial susceptibility testing, 20th international supplements. CLSI Document M100-S20. Wayne, Pennysylavania, USA: CLSI; 2010.
  • 9 CLSI. Clinical and Laboratory Standards Institute. Performance standards for Antimicrobial susceptibility testing, 21st international supplements. CLSI Document M100-S21. Wayne, Pennysylavania, USA: CLSI; 2011.
  • 10 Conterno LO, Wey SB, Castelo A. Risk factors for mortality in Staphylococcus aureus bacteremia. Infect Control Hosp Epidemiol 1998;19:32-7.
  • 11 Kanafani ZA, Kourany WM, Fowler VG Jr, Levine DP, Vigliani GA, Campion M, et al. Clinical characteristics and outcomes of diabetic patients with Staphylococcus aureus bacteremia and endocarditis. Eur J Clin Microbiol Infect Dis. 2009;28:1477-82.
  • 12 Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB. Nosocomial bloodstream infections in US hospitals: Analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 2004;39:309-17.
  • 13 Ribas RM, Freitas C, Gontijo Filho PP. Nosocomial bloodstream infections: Organisms, risk factors and resistant phenotypes in the Brazilian University Hospital. Braz J Infect Dis 2007;11:351-4.
  • 14 Kaech C, Elzi L, Sendi P, Frei R, Laifer G, Bassetti S, et al. Course and outcome of Staphylococcus bacteremia: A retrospective analysis of 308 episodes in a Swiss tertiary-care centre. Clin Microbiol Infect 2006;12:345-52.
  • 15 Lautenschlager S, Herzog C, Zimmerli W. Course and outcome of bacteremia due to Staphylococcus aureus: Evaluation of different clinical case definitions. Clin Infect Dis 1993;16:567-73.
  • 16 Wyllie DH, Crook DW, Peto TE. Mortality after Staphylococcus aureus bacteremia in two hospitals in Oxfordshire, 1997-2003: Cohort study. BMJ 2006;333:281.
  • 17 Jensen AG, Wachmann CH, Espersen F, Scheibel J, Skinhoi P, Frimodt-Moller N. Treatment and outcome of Staphylococcus aureua bacteremia: A prospective study of 278 cases. Arch Intern Med 2002;162:25-32.
  • 18 Cunney RJ, McNamara EB, Ansari NA, Smyth EG. Community-acquired and hospital-acquired Staphylococcus aureus septicemia: 115 cases from a Dublin teaching hospital. J Infect 1996;33:11-3.
  • 19 Laupland KB, Ross T, Gregson DB. Staphylococcus aureus bloodstream infections: Risk factors, outcomes and the influence of methicillin resistance in Calgary, Canada, 2000-2006. J Infect Dis 2008;198:336-43.
  • 20 Favre B, Hugonnet S, Correa L, Sax H, Rohner P, Pittet D. Nosocomial bacteremia: Clinical significance of a single blood culture positive for coagulase negative staphylococci. Infect Control Hosp Epidemiol 2005;26:697-702.