Clinical characteristics and risk factors of Staphylococcus aureus bloodstream infection in a tertiary-care hospital in China: a single-center retrospective 11-year study.

BACKGROUND

Staphylococcus aureus (SA) is one of the most important pathogens of bloodstream infection (BSI). Because of its high morbidity and mortality, Staphylococcus aureus bloodstream infection (SA-BSI) poses a serious threat to public health. We sought to analyze the clinical characteristics, drug resistance and risk factors of poor prognosis in patients with SA-BSI.

METHODS

The clinical data of 430 patients with SA-BSI in the First Affiliated Hospital of Bengbu Medical University from January 2013 to October 2024 were analyzed retrospectively. Univariate and multivariate logistic regression analysis was used to analyze the risk factors of poor prognosis.

RESULTS

Among the 430 cases of SA-BSI, the isolation rate of MRSA was 50.47% (217/430) and the incidence of poor prognosis was 18.14% (78/430). The rates of admission to ICU, respiratory failure, central venous catheterization, endotracheal intubation, urinary catheter, tracheotomy and non-invasive mechanical ventilation in MRSA group were significantly higher than those in MSSA group (p < 0.05). Respiratory failure (OR = 6.565, 95%Cl: 1.275 ~ 33.803, p = 0.024), septic shock (OR = 7.185, 95%Cl: 1.15 ~ 44.874, p = 0.035), high Pitt bacteremia score (OR = 2.156, 95%Cl: 1.752 ~ 2.653, p < 0.001) and high serum procalcitonin level (OR = 1.064, 95%Cl: 1.025 ~ 1.104, p = 0.001) were independent risk factors for poor prognosis in patients with SA-BSI.

CONCLUSION

Patients with respiratory failure, ICU admission, or indwelling catheters are at increased risk for MRSA bloodstream infection, while respiratory failure, septic shock, high Pitt bacteremia score, and elevated procalcitonin may worsen prognosis of patients with SA-BSI. To improve outcomes, clinicians should implement targeted interventions, including enhanced screening and contact precautions for high-risk patients, judicious management of invasive devices, and antimicrobial stewardship with early source control. Strengthening risk assessment and these measures can optimize SA-BSI management and patient prognosis.