TY - JOUR

T1 - Prevalence and Mortality of Infective Endocarditis in Community-Acquired and Healthcare-Associated Staphylococcus aureus Bacteremia

T2 - A Danish Nationwide Registry-Based Cohort Study

AU - Ostergaard, Lauge

AU - Voldstedlund, Marianne

AU - Bruun, Niels Eske

AU - Bundgaard, Henning

AU - Iversen, Kasper

AU - Kober, Nana

AU - Dahl, Anders

AU - Chamat-Hedemand, Sandra

AU - Petersen, Jeppe Kofoed

AU - Jensen, Andreas Dalsgaard

AU - Christensen, Jens Jorgen

AU - Rosenvinge, Flemming Schonning

AU - Jarlov, Jens Otto

AU - Moser, Claus

AU - Andersen, Christian Ostergaard

AU - Coia, John

AU - Marmolin, Ea Sofie

AU - Sogaard, Kirstine K.

AU - Lemming, Lars

AU - Kober, Lars

AU - Fosbol, Emil Loldrup

PY - 2022

Y1 - 2022

N2 - Community-acquired Staphylococcus aureus bacteremia (SAB) was associated with twice the odds for infective endocarditis (IE), as compared with healthcare-associated SAB. We identified no significant difference in short-term mortality between community-acquired and healthcare-associated S aureus IE.Background Staphylococcus aureus bacteremia (SAB) can be community-acquired or healthcare-associated, and prior small studies have suggested that this mode of acquisition impacts the subsequent prevalence of infective endocarditis (IE) and patient outcomes. Methods First-time SAB was identified from 2010 to 2018 using Danish nationwide registries and categorized into community-acquired (no healthcare contact within 30 days) or healthcare-associated (SAB >48 hours of hospital admission, hospitalization within 30 days, or outpatient hemodialysis). Prevalence of IE (defined from hospital codes) was compared between groups using multivariable adjusted logistic regression analysis. One-year mortality of S aureus IE (SAIE) was compared between groups using multivariable adjusted Cox proportional hazard analysis. Results We identified 5549 patients with community-acquired SAB and 7491 with healthcare-associated SAB. The prevalence of IE was 12.1% for community-acquired and 6.6% for healthcare-associated SAB. Community-acquired SAB was associated with a higher odds of IE as compared with healthcare-associated SAB (odds ratio, 2.12 [95% confidence interval {CI}, 1.86-2.41]). No difference in mortality was observed with 0-40 days of follow-up for community-acquired SAIE as compared with healthcare-associated SAIE (HR, 1.07 [95% CI, .83-1.37]), while with 41-365 days of follow-up, community-acquired SAIE was associated with a lower mortality (HR, 0.71 [95% CI, .53-.95]). Conclusions Community-acquired SAB was associated with twice the odds for IE, as compared with healthcare-associated SAB. We identified no significant difference in short-term mortality between community-acquired and healthcare-associated SAIE. Beyond 40 days of survival, community-acquired SAIE was associated with a lower mortality.

AB - Community-acquired Staphylococcus aureus bacteremia (SAB) was associated with twice the odds for infective endocarditis (IE), as compared with healthcare-associated SAB. We identified no significant difference in short-term mortality between community-acquired and healthcare-associated S aureus IE.Background Staphylococcus aureus bacteremia (SAB) can be community-acquired or healthcare-associated, and prior small studies have suggested that this mode of acquisition impacts the subsequent prevalence of infective endocarditis (IE) and patient outcomes. Methods First-time SAB was identified from 2010 to 2018 using Danish nationwide registries and categorized into community-acquired (no healthcare contact within 30 days) or healthcare-associated (SAB >48 hours of hospital admission, hospitalization within 30 days, or outpatient hemodialysis). Prevalence of IE (defined from hospital codes) was compared between groups using multivariable adjusted logistic regression analysis. One-year mortality of S aureus IE (SAIE) was compared between groups using multivariable adjusted Cox proportional hazard analysis. Results We identified 5549 patients with community-acquired SAB and 7491 with healthcare-associated SAB. The prevalence of IE was 12.1% for community-acquired and 6.6% for healthcare-associated SAB. Community-acquired SAB was associated with a higher odds of IE as compared with healthcare-associated SAB (odds ratio, 2.12 [95% confidence interval {CI}, 1.86-2.41]). No difference in mortality was observed with 0-40 days of follow-up for community-acquired SAIE as compared with healthcare-associated SAIE (HR, 1.07 [95% CI, .83-1.37]), while with 41-365 days of follow-up, community-acquired SAIE was associated with a lower mortality (HR, 0.71 [95% CI, .53-.95]). Conclusions Community-acquired SAB was associated with twice the odds for IE, as compared with healthcare-associated SAB. We identified no significant difference in short-term mortality between community-acquired and healthcare-associated SAIE. Beyond 40 days of survival, community-acquired SAIE was associated with a lower mortality.

KW - community-acquired

KW - endocarditis

KW - healthcare-associated

KW - infective endocarditis

KW - Staphylococcus aureus bacteremia

KW - RISK-FACTORS

KW - PATIENT REGISTRY

KW - ECHOCARDIOGRAPHY

KW - SYSTEM

KW - TOOL

U2 - 10.1093/ofid/ofac647

DO - 10.1093/ofid/ofac647

M3 - Journal article

C2 - 36540385

VL - 9

JO - Open Forum Infectious Diseases

JF - Open Forum Infectious Diseases

SN - 2328-8957

IS - 12

M1 - 647

ER -