Resumen
Background
Hemodialysis patients are frequently colonized by Staphylococcus aureus, leading to severe infections with high mortality rates. However, little is known about transition from non-colonization to colonization or bacteremia over time. The aim was to analyze the
behavior of S. aureus colonization, identifying the probability of transition from non-colonized to colonized state or bacteremia, and
the influence of some covariates.
Methods
The study was conducted in a dialysis unit associated with a high complexity hospital in Medellín between October 2017 and October
2019. An initial measurement was taken to evaluate S. aureus colonization, and follow-up measurements were performed 2 and 6
months later. Bacteremia evolution was monitored for 12 months. A two-state recurrent continuous-time Markov model was constructed to model transition dynamics from non-colonization to S. aureus colonization in hemodialysis patients. Subsequently, the model was applied to a third state of bacteremia.
Results
Of 178 patients on hemodialysis, 30.3% were colonized by S. aureus. Transition intensity from non-colonization to colonization was three times higher (0.21; CI: 0.14-0.29) than from colonization to noncolonization (0.07; CI: 0.05-0.11). The colonization risk increased in patients with previous infections (HR: 2.28; CI: 0.78-6.68), hospitalization (HR: 1.29; CI: 0.56-2.99) and antibiotics consumption
(HR: 1.17; CI: 0.53-2.58). Mean non-colonized state duration was 10.9 months, while in the colonized state was 5.2 months. In the 3-state
model, it was found that patients colonized were more likely to develop S. aureus infection (13.9%).
Conclusion
A more likely transition from non-colonization to colonization was found, which increases with factors such as previous infection. In
addition, the development of bacteremia was more likely in colonized than in non-colonized patients. These results underline the
importance of surveillance and proper management of S. aureus colonization to prevent serious complications, such as bacteremia,
and improve prognosis in this vulnerable population.
Hemodialysis patients are frequently colonized by Staphylococcus aureus, leading to severe infections with high mortality rates. However, little is known about transition from non-colonization to colonization or bacteremia over time. The aim was to analyze the
behavior of S. aureus colonization, identifying the probability of transition from non-colonized to colonized state or bacteremia, and
the influence of some covariates.
Methods
The study was conducted in a dialysis unit associated with a high complexity hospital in Medellín between October 2017 and October
2019. An initial measurement was taken to evaluate S. aureus colonization, and follow-up measurements were performed 2 and 6
months later. Bacteremia evolution was monitored for 12 months. A two-state recurrent continuous-time Markov model was constructed to model transition dynamics from non-colonization to S. aureus colonization in hemodialysis patients. Subsequently, the model was applied to a third state of bacteremia.
Results
Of 178 patients on hemodialysis, 30.3% were colonized by S. aureus. Transition intensity from non-colonization to colonization was three times higher (0.21; CI: 0.14-0.29) than from colonization to noncolonization (0.07; CI: 0.05-0.11). The colonization risk increased in patients with previous infections (HR: 2.28; CI: 0.78-6.68), hospitalization (HR: 1.29; CI: 0.56-2.99) and antibiotics consumption
(HR: 1.17; CI: 0.53-2.58). Mean non-colonized state duration was 10.9 months, while in the colonized state was 5.2 months. In the 3-state
model, it was found that patients colonized were more likely to develop S. aureus infection (13.9%).
Conclusion
A more likely transition from non-colonization to colonization was found, which increases with factors such as previous infection. In
addition, the development of bacteremia was more likely in colonized than in non-colonized patients. These results underline the
importance of surveillance and proper management of S. aureus colonization to prevent serious complications, such as bacteremia,
and improve prognosis in this vulnerable population.
| Idioma original | Inglés |
|---|---|
| Publicación | F1000Research |
| Volumen | 13 |
| Estado | Publicada - jul. 2024 |
Tipos de Productos Minciencias
- Artículos de investigación con calidad A1 / Q1