WASHINGTON — Three clinical characteristics—arteriovenous shunts or grafts, history of methicillin-resistant Staphylococcus aureus, and the presence of chills—were significantly associated with S. aureus bacteremia in a study of 1,015 patients, Dr. Zeina A. Kanafani reported in a poster presented at the annual meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy.
The findings may facilitate earlier detection of infection and encourage the timely initiation of antibiotics in bacteremic patients, noted Dr. Kanafani and her colleagues at Duke University Medical Center in Durham, N.C.
Data were collected from hospitalized patients aged 18 years and older with fevers of at least 38° C who underwent blood cultures between December 2003 and December 2004. A total of 235 patients (23%) had positive blood cultures; 76 were excluded from the study due to possible culture contamination.
Of the remaining 159 patients (7.7% of the original patient population), 78 had S. aureus bacteremia; the other 81 patients grew organisms including Candida species, Enterococcus species, and Bacteroides species.
Overall, 15 (19%) of patients with S. aureus bacteremia had histories of S. aureus infection, compared with 42 (5%) of the 780 patients whose blood cultures were negative for bacteremia. In addition, 25 (32%) of bacteremia patients had an arteriovenous shunt or graft, compared with 74 (10%) of culture-negative patients, and 34 (44%) of bacteremia patients suffered from chills, compared with 126 (16%) of the culture-negative patients.
In a subgroup of 829 nonhemodialysis patients, 45 (5%) had S. aureus bacteremia, and these patients were significantly more likely to have a tunneled-cuff catheter and a history of methicillin-resistant S. aureus.
The meeting was sponsored by the American Society for Microbiology.