Iranian Journal of Pathology

Factors Associated with In-Hospital Mortality in Adult Patients with Community-Acquired Staphylococcus aureus Bacteremia: A Cross-Sectional Study

Document Type : Original Research

Authors

Sogol Alikarami 1
Ghazal Razani 2
SeyedAhmad SeyedAlinaghi 3, 4
Arash Seifi 5
Alireza Abdollahi 6
Nazanin Anaraki 2
Sara Ghaderkhani 6

1 Pain Research Center, Neuroscience Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

2 School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

3 Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran

4 Research Development Center, Arash Women Hospital, Tehran University of Medical Sciences, Tehran, Iran.

5 Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

6 Department of Pathology, Imam Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

https://doi.org/10.30699/ijp.2025.2052150.3409
Abstract
Background & Objective: Community-acquired Staphylococcus aureus bacteremia (CA-SAB) is associated with substantial morbidity, mortality, and healthcare costs. This study aimed to identify clinical and laboratory factors associated with in-hospital mortality among patients with CA-SAB.
Methods: This retrospective cross-sectional study was conducted at a tertiary referral hospital in Tehran, Iran. Adult patients with positive blood cultures for S. aureus who met CA-SAB criteria were included. Demographic, clinical, and laboratory data were collected from medical records. The primary outcome was in-hospital mortality. Univariate and multivariate logistic regression analyses were performed to assess associations with mortality.
Results: A total of 114 patients with CA-SAB were included. No significant association was observed between underlying comorbidities and mortality. Although methicillin-resistant S. aureus (MRSA) infection was associated with a higher mortality rate, this difference was not statistically significant (P = .32). Multivariate analysis revealed that older age (odds ratio [OR], 1.053; 95% CI, 1.012–1.095; P = .01), elevated C-reactive protein (CRP) levels (OR, 1.016; 95% CI, 1.005–1.028; P < .01), and lower serum albumin levels (OR, 0.249; 95% CI, 0.097–0.642; P < .01) were independently associated with in-hospital mortality.
Conclusion: Although age was not significant in univariate analysis, it emerged as a significant predictor after adjustment for other variables. Routine laboratory parameters such as CRP and albumin may serve as valuable prognostic indicators. Early identification of high-risk patients using these markers could inform timely interventions and improve outcomes in CA-SAB.

Keywords

Staphylococcus aureus
bacteremia
mortality
community-acquired infections
methicillin resistance

Subjects

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Iranian Journal of Pathology
Volume 20, Issue 4
Summer 2025
Pages 454-462

  • Receive Date 31 January 2025
  • Revise Date 18 May 2025
  • Accept Date 18 June 2025

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