P-803. A 10-year Retrospective Analysis of Staphylococcus aureus Bacteremia in a Philippine Tertiary Hospital

Abstract Background Staphylococcus aureus is a frequent cause of bacteremia in community and health care settings. There is limited data on S. aureus bacteremia (SAB) in the Philippines. This study describes the demographic profile and clinical characteristics of adult patients with SAB and their association with in-hospital mortality. Methods Patients aged ≥ 18 years with SAB from 1/1/2013 to 12/31/2023 were reviewed for study inclusion. SAB was defined as at least one blood culture result positive for S. aureus. Clinical characteristics, comorbidities, sources of infection, and clinical outcomes were recorded. Stepwise regression analysis was performed using STATA 13.1. Results 314 patients with SAB were included; over half were male (185/314, 59%) and majority (62.5%) had Methicillin Susceptible Staphylococcus aureus (MSSA) bacteremia. The most common comorbidities were diabetes mellitus (146/314, 46.5%) and end stage renal disease (92/314, 29.3%). Mortality was high at 24.5% (77/314). Deceased patients were significantly older than survivors (65.7 years vs 59.0 years, p = 0.004). Among deceased patients, pleuropulmonary and intravascular catheter-related infections were the most common sources of infection comprising 29/77 (37.7%) and 12/77 (15.6%), respectively. Most patients (252/314, 80.3%) were referred to infectious diseases (ID) specialists. Clinical factors significantly associated with in-hospital mortality in the bivariate analysis included older age (OR=1.02, 95% CI 1.01-1.04), active malignancy (OR=3.25, 95% CI 1.68-6.26), hepatic failure (OR=3.25, 95% CI 1.01-10.51), hospital-acquired SAB (OR=3.97, 95% CI 2.09-7.53), septic shock (OR=54.0, 95% CI 7.2-404), and ICU admission (OR=22.17, 95% CI 9.16-53.69). In the multivariate regression model, hospital-acquired SAB (OR = 3.79, 95% CI 1.05 – 13.72, p = 0.002) and septic shock (OR = 1972.07, 95% CI 120.25 – 32339.3, p = < 0.001) increased the odds of in-hospital mortality, while referral to ID was protective (OR=0.11, 95% CI 0.01 – 0.90, p = 0.40). Conclusion The high mortality rate of SAB in this study is comparable to published data. Hospital-acquired SAB and the presence of septic shock significantly affect in-hospital mortality. Referral to ID specialist is associated with improved survival. Disclosures Karl Evans R. Henson, MD, FIDSA, BSV Biosciences: Honoraria|Cathay Drug Company, Inc: Grant/Research Support|MSD: Honoraria|Pfizer: Advisor/Consultant|Pfizer: Honoraria