Association of Staphylococcus aureus Bacterial Load and Colonization Sites With the Risk of Postoperative S. aureus Infection.

Autor: Troeman DPR; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., Hazard D; Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany., van Werkhoven CHW; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., Timbermont L; Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium., Malhotra-Kumar S; Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium., Wolkewitz M; Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany., Ruzin A; Microbial Sciences, R&D BioPharmaceuticals, AstraZeneca, Gaithersburg, Maryland, USA., Sifakis F; Gilead Sciences, Inc, Foster City, California, USA., Harbarth S; Infection Control Programme and WHO Collaborating Center, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland., Kluytmans JAJW; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.; Department of Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2024 Jul 23; Vol. 11 (8), pp. ofae414. Date of Electronic Publication: 2024 Jul 23 (Print Publication: 2024).
DOI: 10.1093/ofid/ofae414
Abstrakt: Background: The independent effects of extranasal-only carriage, carriage at multiple bodily sites, or the bacterial load of colonizing Staphylococcus aureus (SA) on the risk of developing SA surgical site infections and postoperative bloodstream infections (SA SSI/BSIs) are unclear. We aimed to quantify these effects in this large prospective cohort study.
Methods: Surgical patients aged 18 years or older were screened for SA carriage in the nose, throat, or perineum within 30 days before surgery. SA carriers and noncarriers were enrolled in a prospective cohort study in a 2:1 ratio. Weighted multivariable Cox proportional hazard models were used to assess the independent associations between different measures of SA carriage and occurrence of SA SSI/BSI within 90 days after surgery.
Results: We enrolled 5004 patients in the study cohort; 3369 (67.3%) were SA carriers. 100 SA SSI/BSI events occurred during follow-up, and 86 (86%) of these events occurred in SA carriers. The number of colonized bodily sites (adjusted hazard ratio [aHR], 3.5-8.5) and an increasing SA bacterial load in the nose (aHR, 1.8-3.4) were associated with increased SA SSI/BSI risk. However, extranasal-only carriage was not independently associated with SA SSI/BSI (aHR, 1.5; 95% CI, 0.9-2.5).
Conclusions: Nasal SA carriage was associated with an increased risk of SA SSI/BSI and accounted for the majority of SA infections. Higher bacterial load, as well as SA colonization at multiple bodily sites, further increased this risk.
Competing Interests: Potential conflicts of interest. Van Werkhoven reported receiving research grants/in-kind contribution from DaVolterra, BioMerieux, and Limmatech and consultancy fees from Merck/MSD and Sanofi-Pasteur. Ruzin reported being an employee of AstraZeneca and owner of AstraZeneca stock at the time of study conduct. Sifakis reported being an employee at Gilead Sciences and owner of Gilead Sciences stock and an employee of AstraZeneca and owner of AstraZeneca stock at the time of study conduct. All other authors have no competing interests to declare.
(© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
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