Clinical characteristics and outcomes of diabetic patients with Staphylococcus aureus bacteremia and endocarditis
- 4 September 2009
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Journal of Clinical Microbiology & Infectious Diseases
- Vol. 28 (12), 1477-1482
- https://doi.org/10.1007/s10096-009-0808-3
Abstract
The complications from S. aureus bacteremia (SAB) and infective endocarditis (SAIE) are higher in patients with diabetes. We summarize the characteristics and outcome of diabetic patients enrolled in a multicenter trial of daptomycin vs. standard therapy for SAB and SAIE. Adult patients with SAB were randomized to daptomycin 6 mg/kg/day or standard therapy (vancomycin 1 g every 12 h or antistaphylococcal penicillin 2 g every 4 h, both with gentamicin 1 mg/kg every 8 h for 4 days). Clinical success was defined as survival, resolution of S. aureus infection, and clinical outcome of cure or improved 6 weeks after end of therapy. Diabetic patients (86/235) were older, more overweight, and were more likely to present with systemic inflammatory response syndrome (SIRS) and to have complicated SAB. Clinical success rates were similar (67.4% in diabetics and 70.5% in non-diabetics). The mortality rate was significantly higher among diabetic patients (22.1% vs. 11.4%, p = 0.038). In the diabetes subgroup, the clinical success and mortality rates were comparable between the daptomycin and the standard therapy arms. The presence of diabetes is associated with significantly higher mortality in patients with SAB and SAIE. Daptomycin is an alternative therapeutic option in diabetic patients with these serious staphylococcal infections.This publication has 33 references indexed in Scilit:
- Is It Possible to Blind a Trial for Community‐Acquired Pneumonia?Clinical Infectious Diseases, 2008
- Daptomycin versus Standard Therapy for Bacteremia and Endocarditis Caused byStaphylococcus aureusNew England Journal of Medicine, 2006
- Risk factors for recurrence in patients with Staphylococcus aureus infections complicated by bacteremiaDiagnostic Microbiology and Infectious Disease, 2006
- Impact of initial antibiotic choice and delayed appropriate treatment on the outcome of Staphylococcus aureus bacteremiaEuropean Journal of Clinical Microbiology & Infectious Diseases, 2006
- Influence of diabetes mellitus on the clinical manifestations and prognosis of infective endocarditis: A report from the International Collaboration on Endocarditis – Merged DatabaseScandinavian Journal of Infectious Diseases, 2006
- Staphylococcus aureus EndocarditisJAMA, 2005
- Unstable Vancomycin Heteroresistance Is Common among Clinical Isolates of Methiciliin-Resistant Staphylococcus aureusJournal of Clinical Microbiology, 2005
- Infective endocarditis in diabetic and non-diabetic patientsScandinavian Journal of Infectious Diseases, 2004
- LettersDiabetic Medicine, 2000
- Infections in Patients with Diabetes MellitusNew England Journal of Medicine, 1999