The online version of this article (https://doi.org/10.1186/s12879-018-2978-z) contains supplementary material, which is available to authorized users.
Studies have shown that the prognosis of the treatment of methicillin-susceptible S. aureus (MSSA) with glycopeptides is inferior compared to treatment with β-lactam. However, there are only few studies comparing treatment with antistaphylococcal penicillin alone to glycopeptide treatment. The aim of this study was to compare the efficacy of nafcillin, an antistaphylococcal penicillin, with that of glycopeptides as a definitive therapy for MSSA bacteremia.
Patients with MSSA bacteremia recruited from a tertiary referral hospital were enrolled in this retrospective cohort study. Demographic characteristics, laboratory data, and clinical outcome of the treatment were compared between a group receiving nafcillin and a group receiving glycopeptides.
A total of 188 patients with MSSA bacteremia were included in this study. The glycopeptide group had a higher rate of malignancy (28.6 vs. 60.8%, p < 0.001) and proportion of healthcare-associated infections (47.3 vs. 72.2%, p < 0.001) compared to the nafcillin group. The ratio of skin and soft tissue infections (30.0 vs. 16.7%, p = 0.037) and bone and joint infections (17.8 vs. 6.3%, p = 0.022), as well as levels of C-reactive protein (139.60 vs. 107.61 mg/dL, p = 0.022) were higher in the nafcillin group. All-cause 28-day mortality was significantly high in the glycopeptide group (7.7 vs. 20.6%, p = 0.013).
In patients with MSSA bacteremia, all-cause 28-day mortality rate was higher in a group treated with glycopeptides than in a group treated with nafcillin. Therefore, the use of nafcillin should be considered as a definitive therapy for MSSA bacteremia.
Additional file 1: Supplement 1. Antibiotic resistance rate of identified Staphylococcus aureus. (DOCX 21 kb)12879_2018_2978_MOESM1_ESM.docx
Additional file 2: Multivariate analysis of prognostic factors for predicting mortality in patients with MSSA bacteremia, with adjustments for prevalence of malignancy, healthcare-associated infections, and CRP. (DOCX 13 kb)12879_2018_2978_MOESM2_ESM.docx
National Nosocomial Infections Surveillance S. National nosocomial infections surveillance (NNIS) system report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control. 2004;32(8):470–85. CrossRef
Yong D, Shin HB, Kim YK, Cho J, Lee WG, Ha GY, Choi TY, Jeong SH, Lee K, Chong Y, et al. Increase in the prevalence of Carbapenem-resistant Acinetobacter isolates and ampicillin-resistant non-Typhoidal salmonella species in Korea: a KONSAR study conducted in 2011. Infect Chemother. 2014;46(2):84–93. CrossRefPubMedPubMedCentral
McDanel JS, Perencevich EN, Diekema DJ, Herwaldt LA, Smith TC, Chrischilles EA, Dawson JD, Jiang L, Goto M, Schweizer ML. Comparative effectiveness of beta-lactams versus vancomycin for treatment of methicillin-susceptible Staphylococcus Aureus bloodstream infections among 122 hospitals. Clin Infect Dis. 2015;61(3):361–7. CrossRefPubMed
Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ, Kaplan SL, Karchmer AW, Levine DP, Murray BE, et al. Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus Aureus infections in adults and children: executive summary. Clin Infect Dis. 2011;52(3):285–92. CrossRefPubMed
Schweizer ML, Furuno JP, Harris AD, Johnson JK, Shardell MD, McGregor JC, Thom KA, Cosgrove SE, Sakoulas G, Perencevich EN. Comparative effectiveness of nafcillin or cefazolin versus vancomycin in methicillin-susceptible Staphylococcus Aureus bacteremia. BMC Infect Dis. 2011;11:279. CrossRefPubMedPubMedCentral
Hill PC, Birch M, Chambers S, Drinkovic D, Ellis-Pegler RB, Everts R, Murdoch D, Pottumarthy S, Roberts SA, Swager C, et al. Prospective study of 424 cases of Staphylococcus Aureus bacteraemia: determination of factors affecting incidence and mortality. Intern Med J. 2001;31(2):97–103. CrossRefPubMed
Performance standards for antimicrobial disk susceptibility tests. In ., standard-tenth edn. Wayne, Pennsylvania: Clinical and Laboratory Standards Institution; 2009: M02-A09.
Rasmussen JB, Knudsen JD, Arpi M, Schonheyder HC, Benfield T, Ostergaard C. Relative efficacy of cefuroxime versus dicloxacillin as definitive antimicrobial therapy in methicillin-susceptible Staphylococcus Aureus bacteraemia: a propensity-score adjusted retrospective cohort study. J Antimicrob Chemother. 2014;69(2):506–14. CrossRefPubMed
Sterling SA, Puskarich MA, Glass AF, Guirgis F, Jones AE. The impact of the Sepsis-3 septic shock definition on previously defined septic shock patients. Crit Care Med. 2017;
Park GE, Ko JH, Cho SY, Ha YE, Lee NY, Kang CI, Chung DR, Song JH, Peck KR. Empirical combination of a beta-lactam to vancomycin may not improve outcomes of methicillin-susceptible Staphylococcus Aureus bacteremia, compared to vancomycin monotherapy. Eur J Clin Microbiol Infect Dis. 2017;
- Comparison of the efficacy of nafcillin and glycopeptides as definitive therapy for patients with methicillin-susceptible Staphylococcus aureus bacteremia: a retrospective cohort study
Dong Hyun Oh
Jung Ju Kim
Se Ju Lee
Yong Chan Kim
Eun Jin Kim
In Young Jung
Woo Yong Jeong
Su Jin Jeong
Nam Su Ku
Sang Hoon Han
Jun Yong Choi
Young Goo Song
June Myung Kim
- BioMed Central
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