Risk prediction for Staphylococcus aureus surgical site infection following cardiothoracic surgery; A secondary analysis of the V710-P003 trial
Autor: | Hasan S. Jafri, Kristin Ohneberg, Karina Olsen, Fleur P Paling, Frangiscos Sifakis, Martin Wolkewitz, Vance G. Fowler, Jan Kluytmans, Mark J. DiNubile, Stéphan Juergen Harbarth, Marc J. M. Bonten |
---|---|
Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
0301 basic medicine
Bacterial Diseases Male Cardiovascular Procedures Staphylococcus Coronary artery bypass grafting lcsh:Medicine Bacteremia medicine.disease_cause Pathology and Laboratory Medicine 0302 clinical medicine Endocrinology Mathematical and Statistical Techniques Diabetes mellitus Risk Factors Staphylococcal Vaccines/therapeutic use Medicine and Health Sciences 030212 general & internal medicine Prospective Studies Prospective cohort study lcsh:Science Surgical and invasive medical procedures ddc:616 Vaccines Multidisciplinary Surgical Wound Infection/diagnosis/microbiology/prevention & control Vaccination Staphylococcal Vaccines Staphylococcal Infections Middle Aged Bacterial Pathogens Infectious Diseases Staphylococcus aureus Cardiothoracic surgery Medical Microbiology Physical Sciences Female Pathogens Statistics (Mathematics) Research Article Adult medicine.medical_specialty Infectious Disease Control Endocrine Disorders Cardiovascular Surgical Procedures/adverse effects 030106 microbiology Staphylococcal infections Research and Analysis Methods Microbiology 03 medical and health sciences Double-Blind Method Internal medicine medicine Staphylococcus aureus/pathogenicity Surgical Wound Infection Humans Statistical Methods Microbial Pathogens Aged Bacteria business.industry Cardiovascular Surgical Procedures lcsh:R Organisms Biology and Life Sciences Staphylococcal Infections/diagnosis/microbiology/prevention & control medicine.disease Confidence interval Clinical trial Metabolic Disorders lcsh:Q business Mathematics Forecasting |
Zdroj: | PLoS ONE, Vol 13, Iss 3, p e0193445 (2018) PLoS ONE [E], 13(3). Public Library of Science PLOS ONE, Vol. 13, No 3 (2018) P. e0193445 PLoS ONE |
ISSN: | 1932-6203 |
Popis: | Background Identifying patients undergoing cardiothoracic surgery at high risk of Staphylococcus aureus surgical site infection (SSI) is a prerequisite for implementing effective preventive interventions. The objective of this study was to develop a risk prediction model for S. aureus SSI or bacteremia after cardiothoracic surgery based on pre-operative variables. Materials/Methods Data from the Merck Phase IIb/III S. aureus vaccine (V710-P003) clinical trial were analyzed. In this randomized placebo-controlled trial, the effect of preoperative vaccination against S. aureus was investigated in patients undergoing cardiothoracic surgery. The primary outcome was deep/superficial S. aureus SSI or S. aureus bacteremia through day 90 after surgery. Performance, calibration, and discrimination of the final model were assessed. Results Overall 164 out of 7,647 included patients (2.1%) developed S. aureus infection (149 SSI, 15 bacteremia, 28 both). Independent risk factors for developing the primary outcome were pre-operative colonization with S. aureus (OR 3.08, 95% confidence interval [CI] 2.23–4.22), diabetes mellitus (OR 1.87, 95% CI 1.34–2.60), BMI (OR 1.02 per kg/m2, 95% CI 0.99–1.05), and CABG (OR 2.67, 95% CI 1.91–3.78). Although vaccination had a significant (albeit modest) protective effect, it was omitted from the model because its addition did not significantly change the coefficients of the final model and V710-vaccine development has been discontinued due to insufficient efficacy. The final prediction model had moderate discriminative accuracy (AUC-value, 0.72). Conclusion Pre-operative S. aureus colonization status, diabetes mellitus, BMI, and type of surgical procedure moderately predicted the risk of S. aureus SSI and/or bacteremia among patients undergoing cardiothoracic surgery. |
Databáze: | OpenAIRE |
Externí odkaz: | |
Nepřihlášeným uživatelům se plný text nezobrazuje | K zobrazení výsledku je třeba se přihlásit. |