Risk Factors for Hospital-Acquired Staphylococcus aureus Bacteremia

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Abstract
STAPHYLOCOCCUS aureus is one of the most common causes of hospital-acquired bacteremia,1-5 and, despite the availability of potent antistaphylococcal antibiotics, hospital-acquired S aureus bacteremia (SAB) is still a major problem with considerable morbidity and mortality.6-9 Several risk factors have been associated with hospital-acquired SAB, such as an inserted venous catheter, both central and peripheral,7,8,10-22 sex,23-25 immunosuppressive conditions such as cancer,8,11,22,26-28 diabetes mellitus,8,11,12 and alcohol abuse.8 Patients treated with corticosteroids also have an increased risk of S aureus infection in general,29 and anemia,30 blood transfusion,2 and surgical treatment31-33 may influence the risk of acquiring SAB in the hospital. The use of antibiotics seems to play a protective role in hospital-acquired septicemia,2 and several studies call attention to the fact that nasal carriage of S aureus is a major risk factor for wound infections,34-36 infections in patients undergoing hemodialysis,37,38 patients in intensive care units,39-41 and patients with the human immunodeficiency virus or acquired immunodeficiency syndrome.42 Also, hyponatremia has been shown to be a common finding in patients with severe bacterial infections.43 To our knowledge, this study is the first case-control study dealing specifically with hospital-acquired SAB, and the role of several factors and associations according to this infection is discussed to make intervention possible.

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