title: Clinical significance of Staphylococcus aureus bacteremia in patients with liver cirrhosis.
abstract: Patients with liver cirrhosis (LC) have impaired immunity and thus are predisposed to infections. Few studies have attempted to evaluate Staphylococcus aureus bacteremia (SAB) in LC patients. Therefore, this study prospectively evaluated the clinical characteristics and outcomes of 642 episodes of SAB from August 1, 2008 to September 31, 2010. Of 642 patients with SAB, 109 (17.0 %) were classified as LC patients whereas the remaining 533 (83.0 %) were classified as non-LC patients. The 30-day mortality rate of LC patients was significantly higher than that of patients with other diseases (32 % vs. 22 %, respectively; P = 0.047). The 30-day mortality rates of patients with MSSA bacteremia and MRSA bacteremia were not significantly different among LC patients (35.1 % with MSSA vs. 26.9 % with MRSA; P = 0.41). A univariate analysis of the 30-day mortality rate of LC patients with SAB for survivors and non-survivors showed that rapidly fatal or ultimately fatal according to the criteria of McCabe and Jackson (OR 5.0; 95 % CI 1.60-15.65), septic shock at initial presentation (OR 3.5; 95 % CI 1.18-10.39) and Child-Pugh class C (OR 2.8; 95 % CI 1.20-6.59) were associated with increased mortality. In contrast, the removal of the eradicable focus was associated with decreased mortality (OR 0.14; 95 % CI 0.04-0.52). Disease severity and liver dysfunction may be useful for predicting the prognosis of SAB in LC patients.
authors: Departments of Infectious diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea.
authors: H J
authors: HJ
authors: Park
authors: Y-M
authors: YM
authors: Lee
authors: K M
authors: KM
authors: Bang
authors: S-Y
authors: SY
authors: Park
authors: S M
authors: SM
authors: Moon
authors: K-H
authors: KH
authors: Park
authors: Y P
authors: YP
authors: Chong
authors: S-H
authors: SH
authors: Kim
authors: S-O
authors: SO
authors: Lee
authors: S-H
authors: SH
authors: Choi
authors: J-Y
authors: JY
authors: Jeong
authors: J H
authors: JH
authors: Woo
authors: Y S
authors: YS
authors: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000401:mortality* / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000401:mortality* / Q000473:pathology*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D016019:Survival Analysis; D055815:Young Adult