Staphylococcus aureus Bacteraemia in Patients with Chronic Kidney Disease: Single-Centre Data from Pakistan

Abstract

Background: Infection, especially Staphylococcus aureus bacteraemia (SAB), increases morbidity and mortality in patients with chronic kidney disease (CKD), particularly those who are dialysis-dependent. This study describes the clinical features of SAB amongst patients with CKD. Method: The authors planned a retrospective observational study of adult patients with CKD and SAB from January 2021–June 2022. Microbiology laboratory data and hospital medical records were reviewed. All detailed clinical data, including baseline characteristics, source of infection, management, methicillin susceptibility of S. aureus isolates, and outcome, were collected. The association between baseline characteristics, source of infection, management, and outcome of patients, was examined. Results: The authors included 49 patients in their study. Methicillin-resistant  S. aureus was more prevalent (35 out of 49; 71.4%) than methicillin-sensitive  S. aureus (14 out of 49; 28.6%). Central venous catheter was the most common source of infection (38 out of 49; 77.6%). Most patients recovered (26 out of 49; 53.1%), while 12 (24.5%) were referred to other hospitals. Four patients expired. Methicillin-resistant S. aureus bacteraemia had higher mortality than methicillin-sensitive S. aureus bacteraemia. Central line-associated bloodstream infections showed higher mortality than other sources of infection, although due to a small sample size, this difference could not be proven statistically. SAB showed significant association with patient outcomes. The central venous catheter could not be removed in three of four expired patients (p=0.018). Conclusion: SAB is a serious but preventable nosocomial infection in patients with CKD who are dependent on dialysis. Strict infection prevention measures are needed to prevent hospital-acquired infections in these patients.