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dc.contributor.author Nickerson, EK
dc.contributor.author Hongsuwan, M
dc.contributor.author Limmathurotsakul, D
dc.contributor.author Wuthiekanun, V
dc.contributor.author Shah, KR
dc.contributor.author Srisomang, P
dc.contributor.author Mahavanakul, W
dc.contributor.author Wacharaprechasgul, T
dc.contributor.author Jr, VGF
dc.contributor.author West, TE
dc.contributor.author Teerawatanasuk, N
dc.contributor.author Becher, H
dc.contributor.author White, NJ
dc.contributor.author Chierakul, W
dc.contributor.author Day, NP
dc.contributor.author Peacock, SJ
dc.date.accessioned 2011-06-21T17:31:26Z
dc.date.issued 2009
dc.identifier.citation PLoS ONE, 2009, 4 (1)
dc.identifier.issn 1932-6203
dc.identifier.uri http://hdl.handle.net/10161/4512
dc.description.abstract Background: Most information on invasive Staphylococcus aureus infections comes from temperate countries. There are considerable knowledge gaps in epidemiology, treatment, drug resistance and outcome of invasive S. aureus infection in the tropics. Methods: A prospective, observational study of S. aureus bacteraemia was conducted in a 1000-bed regional hospital in northeast Thailand over 1 year. Detailed clinical data were collected and final outcomes determined at 12 weeks, and correlated with antimicrobial susceptibility profiles of infecting isolates. Principal Findings: Ninety-eight patients with S. aureus bacteraemia were recruited. The range of clinical manifestations was similar to that reported from temperate countries. The prevalence of endocarditis was 14%. The disease burden was highest at both extremes of age, whilst mortality increased with age. The all-cause mortality rate was 52%, with a mortality attributable to S. aureus of 44%. Methicillin-resistant S. aureus (MRSA) was responsible for 28% of infections, all of which were healthcare-associated. Mortality rates for MRSA and methicillin-susceptible S. aureus (MSSA) were 67% (18/27) and 46% (33/71), respectively (p = 0.11). MRSA isolates were multidrug resistant. Only vancomycin or fusidic acid would be suitable as empirical treatment options for suspected MRSA infection. Conclusions: S. aureus is a significant pathogen in northeast Thailand, with comparable clinical manifestations and a similar endocarditis prevalence but higher mortality than industrialised countries. S. aureus bacteraemia is frequently associated with exposure to healthcare settings with MRSA causing a considerable burden of disease. Further studies are required to define setting-specific strategies to reduce mortality from S. aureus bacteraemia, prevent MRSA transmission, and to define the burden of S. aureus disease and emergence of drug resistance throughout the developing world. © 2009 Nickerson et al.
dc.language.iso en_US en_US
dc.relation.ispartof PLoS ONE
dc.relation.isversionof 10.1371/journal.pone.0004308
dc.title Staphylococcus aureus bacteraemia in a tropical setting: Patient outcome and impact of antibiotic resistance
dc.title.alternative en_US
dc.type Journal Article
dc.description.version Version of Record en_US
duke.date.pubdate 2009-1-30 en_US
duke.description.endpage e4308 en_US
duke.description.issue 1 en_US
duke.description.startpage e4308 en_US
duke.description.volume 4 en_US
dc.relation.journal Plos One en_US
pubs.issue 1
pubs.organisational-group /Duke
pubs.organisational-group /Duke/School of Medicine
pubs.organisational-group /Duke/School of Medicine/Basic Science Departments
pubs.organisational-group /Duke/School of Medicine/Basic Science Departments/Molecular Genetics and Microbiology
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments/Medicine
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments/Medicine/Medicine, Infectious Diseases
pubs.organisational-group /Duke/School of Medicine/Institutes and Centers
pubs.organisational-group /Duke/School of Medicine/Institutes and Centers/Duke Clinical Research Institute
pubs.volume 4

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