Immune Dysfunction Prior to Staphylococcus aureus Bacteremia Is a Determinant of Long-Term Mortality
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{"title"=>"Immune dysfunction prior to Staphylococcus aureus bacteremia is a determinant of long-term mortality", "type"=>"journal", "authors"=>[{"first_name"=>"Jared A.", "last_name"=>"Greenberg", "scopus_author_id"=>"56817133700"}, {"first_name"=>"Michael Z.", "last_name"=>"David", "scopus_author_id"=>"36885214100"}, {"first_name"=>"Jesse B.", "last_name"=>"Hall", "scopus_author_id"=>"7407379160"}, {"first_name"=>"John P.", "last_name"=>"Kress", "scopus_author_id"=>"7102402050"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "pmid"=>"24505428", "doi"=>"10.1371/journal.pone.0088197", "scopus"=>"2-s2.0-84895541252", "pui"=>"372535178", "sgr"=>"84895541252"}, "id"=>"665f0a07-db91-3d7e-b795-4ecaceb88bf4", "abstract"=>"PURPOSE The clinical implications for patients who survive serious infections are not well understood. It has been hypothesized that the excess mortality for survivors of sepsis observed in epidemiological studies is due to increased vulnerability to subsequent infections. We undertook this study to identify characteristics of patients who are at high risk for death after surviving a common type of blood-stream infection. MATERIALS AND METHODS At a single academic medical center, 237 patients with Staphylococcus aureus bacteremia admitted during a three-year period were retrospectively identified. The primary outcomes were 30-day and 31 to 90-day mortality after the first positive blood culture. The primary predictor variable of interest was clinical immune dysfunction prior to bacteremia. RESULTS The 30-day mortality was not significantly different for patients with and without prior immune dysfunction. However, during days 31 to 90, 11 patients (20%) with prior immune dysfunction compared to 10 patients (8.6%) without prior immune dysfunction died (OR 2.59, 95% CI 1.03-6.53, p = 0.04). In a Cox-proportional hazard model controlling for age, there was a significant association between prior immune dysfunction and greater 31 to 90 day mortality (HR 2.44, 95% CI 1.01-5.90, p = 0.05) and a non-significant trend towards occurrence of subsequent infections and greater 31 to 90 day mortality (HR 2.12, 95% CI 0.89-5.07, p = 0.09). CONCLUSIONS Patients with prior immune dysfunction are at high risk for death 31 to 90 days, but not <30 days, after S. aureus bacteremia. Further investigation is needed to determine if this finding is due to poor prognosis of chronic disease or increased vulnerability to subsequent infections.", "link"=>"http://www.mendeley.com/research/immune-dysfunction-prior-staphylococcus-aureus-bacteremia-determinant-longterm-mortality", "reader_count"=>11, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>3, "Librarian"=>1, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>4, "Other"=>1, "Student > Master"=>1}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>3, "Librarian"=>1, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>4, "Other"=>1, "Student > Master"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>1, "Nursing and Health Professions"=>1, "Medicine and Dentistry"=>3, "Agricultural and Biological Sciences"=>3, "Social Sciences"=>1, "Computer Science"=>1, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>3}, "Social Sciences"=>{"Social Sciences"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Unspecified"=>{"Unspecified"=>1}}, "reader_count_by_country"=>{"Colombia"=>1}, "group_count"=>1}

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PMC Usage Stats | Further Information

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Relative Metric

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