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Predictors of Poor Outcome in S. Aureus Wound Infection
Author(s) -
Tibor L.,
Cramton S.E.,
Hopf H.W.,
Götz F.,
Hunt T.K.
Publication year - 2004
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/j.1067-1927.2004.0abstractbh.x
Subject(s) - medicine , staphylococcus aureus , sepsis , diabetes mellitus , antibiotics , methicillin resistant staphylococcus aureus , staphylococcal infections , antibiotic resistance , amputation , surgery , microbiology and biotechnology , bacteria , biology , genetics , endocrinology
Objectives : Staphylococcus aureus is the most common bacterium cultured from infected wounds. We hypothesized that diabetes mellitus (DM) and/or peripheral arterial disease would be patient predictors of severe outcomes, defined as amputation, sepsis, or death, and infections caused by resistant strains would be bacterial predictors of severe outcomes. Methods : With IRB approval, 50 S. aureus strains (45 wound, 5 central line) were isolated during routine clinical care. Investigations included antibiotic resistance (>5 mcg/ml), and PCR for STAR elements. Chart review included wound type, location, relevant comorbidities, antibiotic resistance, and outcome. Results :Outcome n (% of outcome total )Severe All others TotalDiabetic 7 (70) 6 (17) 13 (29) Non‐diabetic 3 (30) 29 (83) 32 (71) MRSA STAR groups 2 (20) 8 (23) 10 (22) All other STAR 8 (80) 27 (77) 35 (78) MRSA 4 (40) 8 (23) 12 (27) MSSA 6 (60) 27 (77) 33 (73) Total patients 10 (22) 35 (78) 45No non‐DM patient with arterial disease (n = 6) had a poor outcome.Conclusions : The strongest predictor of outcome was the presence of DM. Patients with severe outcomes were slightly more likely to have MRSA infection, although only 33% of patients with MRSA had severe outcomes. Although STAR/ arsRBC groups have been shown previously to predict antibiotic resistance, in this collection there was no correlation between these molecular markers and outcome. This study shows that the strongest predictor of clinical outcome in wound infection is patient‐dependent, while bacterial factors appear to play a lesser role.