title: Comparison of community-onset Staphylococcus argenteus and Staphylococcus aureus sepsis in Thailand: a prospective multicentre observational study.
abstract: Staphylococcus argenteus is a globally distributed cause of human infection, but diagnostic laboratories misidentify this as Staphylococcus aureus. We determined whether there is clinical utility in distinguishing between the two. A prospective cohort study of community-onset invasive staphylococcal sepsis was conducted in adults at four hospitals in northeast Thailand between 2010 and 2013. Of 311 patients analysed, 58 (19%) were infected with S. argenteus and 253 (81%) with S. aureus. Most S. argenteus (54/58) were multilocus sequence type 2250. Infection with S. argenteus was more common in males, but rates of bacteraemia and drainage procedures were similar in the two groups. S. argenteus precipitated significantly less respiratory failure than S. aureus (5.2% versus 20.2%, adjusted OR 0.21, 95% CI 0.06-0.74, p 0.015), with a similar but non-significant trend for shock (6.9% versus 12.3%, adjusted OR 0.46, 95% CI 0.15-1.44, p 0.18). This did not translate into a difference in death at 28 days (6.9% versus 8.7%, adjusted OR 0.80, 95% CI 0.24-2.65, p 0.72). S. argenteus was more susceptible to antimicrobial drugs compared with S. aureus, and contained fewer toxin genes although pvl was detected in 16% (9/58). We conclude that clinical differences exist in association with sepsis due to S. argenteus versus S. aureus.
authors.affiliation: Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. Electronic address: narisara@tropmedres.ac.
authors.forename: N
authors.initials: N
authors.lastname: Chantratita
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: C
authors.initials: C
authors.lastname: Wikraiphat
authors.affiliation: Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Tandhavanant
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: G
authors.initials: G
authors.lastname: Wongsuvan
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: P
authors.initials: P
authors.lastname: Ariyaprasert
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: P
authors.initials: P
authors.lastname: Suntornsut
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: J
authors.initials: J
authors.lastname: Thaipadungpanit
authors.affiliation: Department of Clinical Pathology, Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand.
authors.forename: N
authors.initials: N
authors.lastname: Teerawattanasook
authors.affiliation: Department of Clinical Pathology, Udon Thani Regional Hospital, Udon Thani, Thailand.
authors.forename: Y
authors.initials: Y
authors.lastname: Jutrakul
authors.affiliation: Department of Clinical Pathology, Khon Kaen Regional Hospital, Khon Kaen, Thailand.
authors.forename: N
authors.initials: N
authors.lastname: Srisurat
authors.affiliation: Department of Clinical Pathology, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand.
authors.forename: P
authors.initials: P
authors.lastname: Chaimanee
authors.affiliation: Department of Medicine, Khon Kaen Regional Hospital, Khon Kaen, Thailand.
authors.forename: J
authors.initials: J
authors.lastname: Anukunananchai
authors.affiliation: Department of Medicine, Udon Thani Regional Hospital, Udon Thani, Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Phiphitaporn
authors.affiliation: Department of Pediatrics, Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand.
authors.forename: P
authors.initials: P
authors.lastname: Srisamang
authors.affiliation: Department of Medicine, Faculty of Medicine, Khon Kaen University, Thailand.
authors.forename: P
authors.initials: P
authors.lastname: Chetchotisakd
authors.affiliation: Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, WA, USA; International Respiratory and Severe Illness Center, University of Washington, Seattle, WA, USA.
authors.forename: T E
authors.initials: TE
authors.lastname: West
authors.affiliation: Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Peacock
mesh_terms: D000328:Adult; D000368:Aged; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000473:pathology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000209:etiology; D018805:Sepsis / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology*; D012769:Shock / Q000453:epidemiology / Q000209:etiology; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000473:pathology*; D013210:Staphylococcus / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D016019:Survival Analysis; D013785:Thailand / Q000453:epidemiology; D037521:Virulence Factors / Q000235:genetics
chemical_list: D037521:Virulence Factors
keywords: Prevalence; Staphylococcus argenteus; Staphylococcus aureus; Thailand; sepsis