Profile, risk factors, genotype and outcome of Staphylococcus aureus catheter related blood stream infection in a Malaysian tertiary hospital.

INTRODUCTION

Staphylococcus aureus is a commonly known causative agent of catheter related bloodstream infections (CRBSI) and complicated CRBSI. This study aimed to detect prevalence of S. aureus and complicated S. aureus CRBSI, their virulence genes and evaluate their association with development of complicated CRBSI, patient risk factors and outcomes.

MATERIALS AND

METHODS

A cross-sectional study involving retrospective record review of CRBSI cases was conducted from January 2019 to December 2021. A total of 139 CRBSI cases were identified. Patients' clinical data, risk factors and outcomes of S. aureus CRBSI were analyzed. Nineteen isolates from patients with complicated S. aureus CRBSI were selected for detection of Cna, Chp and Cap8 gene using PCR. The association between the development of complicated S. aureus CRBSI and the presence of virulence genes was analyzed.

RESULTS

Forty-three (31%, n=43) of CRBSI cases were caused by S aureus. Among these, nineteen cases (44.2%) were complicated. Patients with chronic kidney disease (CKD) or end-stage renal failure (ESRF) (adjusted OR 11.11, 95% CI: 2.86-33.33, p<0.001) were at significant risk of S.aureus CRBSI. Virulence genes detected were Cap8 (89.5 %, n=17), Cna (47.4%, n=9) and Chp (26.3%, n=5). The presence of these genes was not significantly associated with the development of complicated S.aureus CRBSI. S. aureus CRBSI were associated with higher mortality (p=0.035).

CONCLUSION

S. aureus was the predominant agent for CRBSI and 44.2% of them were complicated. CKD/ESRF were the comorbidities associated with S. aureus CRBSI. Although cap8 was the most frequently detected virulence gene, it was not associated with the development of complicated S. aureus CRBSI.