Original Research

Staphylococcus aureus bacteraemia cases at Helen Joseph Hospital

Mithra John, Lauren Richards, Jeremy S. Nel
Southern African Journal of Infectious Diseases | Vol 39, No 1 | a626 | DOI: https://doi.org/10.4102/sajid.v39i1.626 | © 2024 Mithra John, Lauren Richards, Jeremy S. Nel | This work is licensed under CC Attribution 4.0
Submitted: 07 February 2024 | Published: 27 May 2024

About the author(s)

Mithra John, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Lauren Richards, Division of Infectious Diseases, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Jeremy S. Nel, Division of Infectious Diseases, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Abstract

Background: Staphylococcus aureus bacteraemia (SAB) is associated with a high mortality. Data on SAB cases in South Africa (SA) are limited.

Objectives: This study aimed to establish the demographic profile, risk factors and complications of patients with SAB in a tertiary inpatient setting.

Method: We conducted a retrospective record review of inpatients above the age of 13 with SAB from October 2015 to November 2022 at Helen Jospeh Hospital (HJH) in Gauteng, SA.

Results: A total of 126 patients with SAB were reviewed. The case fatality ratio among these patients was 20.6% (95% confidence interval [CI]: 13.9–28.8); this was similar for methicillin-sensitive S. aureus and methicillin-resistant S. aureus (p = 0.154). Almost half (49.2%) were community acquired, and these were chiefly associated with skin and soft tissue infections (45.2%), while most healthcare-associated community-acquired infections (18.3%) and nosocomial-related infections (32.5%) were associated with short-term venous catheterisation (40.6%). The most common risk factors for acquiring a SAB were prior hospitalisation in the last 90 days (27.8%), the presence of an invasive device (26.2%) and receipt of haemodialysis (15.1%). Having hypertension (adjusted odds ratio: 5.55 [95% CI: 1.31–23.55]) and being recently hospitalised (adjusted odds ratio: 11.88 [95% CI: 1.84–26.99]) were associated with statistically significant increased odds of death.

Conclusion: SAB-associated all-cause mortality remains high in a middle-income tertiary hospital setting, albeit with a case fatality ratio comparable to that seen in high-income countries.

Contribution: Our study suggests that acceptable outcomes are achievable in tertiary middle-income settings provided there is access to resources including infectious diseases consultation, echocardiograms and basic infection control practices.


Keywords

Staphylococcus aureus; bacteraemia; infectious diseases; inpatients; Helen Joseph Hospital

Sustainable Development Goal

Goal 2: Zero hunger

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