Open AccessRecurrentStaphylococcus aureusBacteremia: Pulsed‐Field Gel Electrophoresis Findings in 29 Patients
Author(s) -
Vance G. Fowler,
Li Kong,
G. Ralph Corey,
Geoffrey S. Gottlieb,
R. Scott McClelland,
Daniel J. Sexton,
Diane GestyPalmer,
Lizzie J. Harrell
Publication year - 1999
Publication title -
the journal of infectious diseases
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 2.69
H-Index - 252
eISSN - 1537-6613
pISSN - 0022-1899
DOI - 10.1086/314712
Subject(s) - bacteremia , staphylococcus aureus , odds ratio , pulsed field gel electrophoresis , medicine , hemodialysis , confidence interval , vancomycin , staphylococcal infections , univariate analysis , surgery , gastroenterology , microbiology and biotechnology , multivariate analysis , antibiotics , biology , bacteria , biochemistry , genetics , genotype , gene
To identify risk factors for relapse among 309 prospectively identified cases of Staphylococcus aureus bacteremia, patients with recurrent S. aureus bacteremia were identified, and pulsed-field gel electrophoresis (PFGE) was performed on isolates from both episodes. PFGE banding patterns from both isolates were identical in 23 patients, consistent with relapsed infection. Patients with PFGE-confirmed relapse were more likely by both univariate and multivariate analyses to have an indwelling foreign body (odds ratio [OR]=18.2, 95% confidence interval [CI]=7. 6-43.6; P<.001), to have received vancomycin therapy (OR=4.1, 95% CI=1.5-11.6; P=.008), or be hemodialysis-dependent (OR=4.1, 95% CI=1. 8-9.3; P=.002) than patients who did not develop recurrent bacteremia. These results suggest that recurrent episodes of S. aureus bacteremia are primarily relapses and are associated with an indwelling foreign body, receiving vancomycin therapy, and hemodialysis dependence.
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