Prognostic impact of hyperglycemia at onset of methicillin-sensitive Staphylococcus aureus bacteraemia

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Forsblom , E , Ruotsalainen , E & Jarvinen , A 2017 , ' Prognostic impact of hyperglycemia at onset of methicillin-sensitive Staphylococcus aureus bacteraemia ' , European Journal of Clinical Microbiology & Infectious Diseases , vol. 36 , no. 8 , pp. 1405-1413 . https://doi.org/10.1007/s10096-017-2946-3

Title: Prognostic impact of hyperglycemia at onset of methicillin-sensitive Staphylococcus aureus bacteraemia
Author: Forsblom, E.; Ruotsalainen, E.; Jarvinen, A.
Contributor: University of Helsinki, Clinicum
University of Helsinki, Infektiosairauksien yksikkö
University of Helsinki, Department of Medicine
Date: 2017-08
Language: eng
Number of pages: 9
Belongs to series: European Journal of Clinical Microbiology & Infectious Diseases
ISSN: 0934-9723
URI: http://hdl.handle.net/10138/238724
Abstract: Previous reports have associated hyperglycemia to poor outcome among aged and comorbid Staphylococcus aureus bacteraemia (SAB) patients. However, the prognostic impact of hyperglycemia in SAB irrespective of age and underlying conditions including a diagnosis of diabetes has received little attention. The objective here was to evaluate the prognostic relevance of hyperglycemia at onset of methicillin-sensitive SAB (MS-SAB). It was a retrospective study of MS-SAB patients. Blood glucose was measured within 24 h of positive blood cultures. The patient cohort was analyzed en bloc and by categorization according to age, underlying conditions and a diagnosis of diabetes. Altogether 161 patients were identified. High initial blood glucose levels were observed among diabetics (p <0.001), patients with deep infections (p <0.05) and poor outcome at 28- or 90-days (p <0.05). Receiver operating characteristics presented the glucose cut-off level of 7.2 mmol/L as a significant predictor of mortality with an area under the curve of 0.63 (95% CI 0.52-0.75, p <0.05). Blood glucose ae7.2 mmol/L connected to higher 28- (9 vs. 20%, p <0.05) and 90-day (14 vs. 29%, p <0.01) mortality. In Cox proportional hazard regression the blood glucose cut-off value of 7.2 mmol/L significantly predicted 90-day mortality (HR, 2.12; 95% CI, 1.01-4.46; p <0.05). Among young and healthy non-diabetics the negative prognostic impact of high glucose was further accentuated (HR 7.46, p <0.05). High glucose levels had no prognostic impact among diabetics. Hyperglycemia at SAB onset may associate to poor outcome. The negative prognostic impact is accentuated among young and healthy non-diabetics.
Subject: COMMUNITY-ACQUIRED PNEUMONIA
BLOOD-STREAM INFECTION
CLINICAL MANAGEMENT
MORTALITY
POPULATION
OUTCOMES
INSULIN
SEPSIS
ADULTS
DEATH
3121 General medicine, internal medicine and other clinical medicine
1183 Plant biology, microbiology, virology
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