Thrombocytopaenia during methicillin-sensitive Staphylococcus aureus bacteraemia

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Forsblom , E , Tielinen , I , Ruotsalainen , E & Jarvinen , A 2017 , ' Thrombocytopaenia during methicillin-sensitive Staphylococcus aureus bacteraemia ' , European Journal of Clinical Microbiology & Infectious Diseases , vol. 36 , no. 5 , pp. 887-896 . https://doi.org/10.1007/s10096-016-2877-4

Title: Thrombocytopaenia during methicillin-sensitive Staphylococcus aureus bacteraemia
Author: Forsblom, E.; Tielinen, I.; Ruotsalainen, E.; Jarvinen, A.
Contributor: University of Helsinki, Clinicum
University of Helsinki, Infektiosairauksien yksikkö
University of Helsinki, Department of Medicine
Date: 2017-05
Language: eng
Number of pages: 10
Belongs to series: European Journal of Clinical Microbiology & Infectious Diseases
ISSN: 0934-9723
URI: http://hdl.handle.net/10138/236789
Abstract: The prognostic impact of thrombocytopaenia in Staphylococcus aureus bacteraemia (SAB) has previously been determined at bacteraemia onset only and relevant pre-bacteraemic thrombocytopaenia predisposing parameters have not been accounted for. We evaluated the prognostic impact of low thrombocyte count in SAB excluding pre-bacteraemic factors potentially causing thrombocytopaenia. This was a multicentre retrospective analysis of methicillin-sensitive SAB (MS-SAB) patients. Thrombocyte count was determined at blood culture collection and at days 3 and 7. Thrombocytopae nia was defined as a thrombocyte count less than 150 x 10(9)/L. Patients with chronic alcoholism, liver diseases and haematologic malignancies were excluded. Altogether, 495 patients were identified. Thrombocytopaenia at blood culture and at day 3 associated to endocarditis (p <0.05 and p <0.01) and defervescence (p <0.001 and p <0.01). Mortality at 90 days was higher for patients with thrombocytopaenia at blood culture collection (26 vs. 16%, p <0.05), at day 3 (32 vs. 13%, p <0.01) and at day 7 (50 vs. 14%, p <0.001). In receiver operating characteristic analyses, thrombocytopaenia predicted a poor outcome at blood culture collection (p <0.05), at day 3 (p <0.001) and at day 7 (p <0.001). When accounting for all prognostic parameters, thrombocytopaenia at day 3 [hazard ratio (HR), 1.83; p = 0.05] demonstrated a trend towards poor outcome, whereas thrombocytopaenia at day 7 (HR, 3.64; p <0.001) associated to poor outcome. Thrombocytopaenia at blood culture collection was not a prognostic parameter when all prognostic factors were taken into account. However, thrombocytopaenia at day 3 indicated a poor outcome and thrombocytopaenia at day 7 was a significant independent negative prognostic marker that has not been previously reported in SAB.
Subject: CRITICALLY ILL PATIENTS
INFECTIVE ENDOCARDITIS
ANTIBIOTIC-TREATMENT
MORTALITY
RESISTANT
MANAGEMENT
COAGULATION
VANCOMYCIN
RECURRENCE
ACTIVATION
3121 Internal medicine
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