Staphylococcus aureus VCF files: Risk Factors for Recurrent Staphylococcus aureus Bacteremia

<p>Background: To understand the clinical, bacterial, and host characteristics associated with recurrent Staphylococcus aureus bacteremia (R-SAB), patients with R-SAB were&nbsp;compared to contemporaneous patients with a single episode of SAB (S-SAB).<br> Methods: All SAB isolates underwent spa genotyping. All isolates from R-SAB patients underwent Pulsed-Field Gel Electrophoresis (PFGE). PFGE-indistinguishable pairs from 40&nbsp;patients underwent whole genome sequencing (WGS). Acute phase plasma from R-SAB and S-SAB patients was matched 1:1 for age, race, gender, and bacterial genotype and&nbsp;underwent cytokine quantification using 25-analyte multiplex bead array.&nbsp;Results: R-SAB occurred in 69 (9.1%) of the 756 study patients. Of the 69 patients, 30 experienced relapse (43.5%) and 39 reinfection (56.5%). Age, race, hemodialysis&nbsp;dependence, presence of foreign body, MRSA, and persistent bacteremia were individually associated with likelihood of recurrence. Multivariate risk modeling revealed that African&nbsp;American (AA) hemodialysis patients were nearly two times more likely (OR = 9.652 [5.402 &ndash; 17.418]) than White hemodialysis patients (OR = 4.53 [1.696 &ndash; 10.879]) to experience&nbsp;R-SAB. WGS confirmed PFGE interpretations in all cases. Median RANTES levels in acute phase plasma from the initial episode of SAB were higher in R-SAB than in matched S-SAB controls ( P = 0.0053, False Discovery Rate &lt; 0.10).&nbsp; &nbsp;<br> Conclusion: This study identified several risk factors for R-SAB. The largest risk for R-SAB is among AA hemodialysis patients. Higher RANTES levels in R-SAB compared to<br> matched controls warrants further study.</p>