title: Delayed peripheral venous catheter-related Staphylococcus aureus bacteremia: onset ≥ 24 hours after catheter removal.
abstract: Peripheral venous catheter (PVC)-associated bacteremia usually develops during the indwelling period. We present a review of 14 patients who developed delayed onset Staphylococcus aureus bacteremia (D-SAB), 1-6 days after PVC removal, and compare them to 29 patients with early onset PVC-related S. aureus bacteremia (E-SAB). At the time of removal, the catheter site exhibited inflammation in 8 (57.1%) cases. At SAB onset, PVC site inflammation developed in all patients. Compared to E-SAB, patients with D-SAB were more often aged ≥ 65 y (71.4% vs. 34.5%; p = 0.03) and on corticosteroids (35.7% vs. 6.9%; p = 0.02). D-SAB was more complicated with persistent (> 3 days) bacteremia (42.9% vs. 13.8%; p = 0.04), metastatic infections (35.7% vs. 6.9%; p = 0.02), and slightly higher mortality (21.4% vs. 10.3%; p = 0.3). Logistic regression revealed that the predictors of D-SAB were corticosteroids (odds ratio (OR) 2.10, 95% confidence intervals (CI) 1.16-58.61) and age ≥ 65 y (OR 1.63, 95% CI 1.12-23.30). These patients may have impaired local/systemic defenses that lead to D-SAB, or a blunted host response with delayed recognition.
authors.affiliation: Department of Internal Medicine Infectious Diseases, Division of Infectious Diseases, St. John Hospital and Medical Center, Grosse Pointe Woods, Michigan 48236, USA.
authors.forename: Kathryn T
authors.initials: KT
authors.lastname: Sanchez
authors.forename: Karam M
authors.initials: KM
authors.lastname: Obeid
authors.forename: Susan
authors.initials: S
authors.lastname: Szpunar
authors.forename: Mohamad G
authors.initials: MG
authors.lastname: Fakih
authors.forename: Riad
authors.initials: R
authors.lastname: Khatib
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000175:diagnosis* / Q000382:microbiology*; D055499:Catheter-Related Infections / Q000175:diagnosis* / Q000382:microbiology*; D002404:Catheterization / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013997:Time Factors