Abstract Background Chronic comorbid conditions represent significant risk for infection in patients with Staphylococcus aureus bacteremia (SAB) 1. How these conditions impact symptom duration (delays in diagnosis) and outcomes, i.e., high morbidity and mortality is poorly understood 2. Our objective was to investigate the associations between comorbidities, symptom duration, and mortality outcomes. Methods This cohort study is a secondary analysis of data from patients who were prospectively enrolled in the Bloodstream Infections Registry at Duke University from July 2015 to August 2022. Participants included adults 18 years or older with a diagnosis of healthcare-associated and non-healthcare-associated community-acquired (HCA-CA p=0.02) (Figure 1). Multivariable regression analysis showed that patients with increased age (OR 1.31, CI 1.20-1.43; p=1.42), myocardial infarction (OR 1.86, CI 1.20-2.85; p=0.004), cerebrovascular accident (OR 1.99, CI 1.29-3.02; p=0.001), hemiplegia (OR 1.63, CI 1.15-2.29; p=0.004), hypertension (OR 1.67, CI 1.15-2.47; p=0.007), and severe liver disease (OR 1.56, CI 1.22-2.01; p 0.00) were higher risk for mortality (Figure 2). The all-cause mortality rate was 29%, and patients with mild liver disease were less likely to die (OR 0.44, CI 0.21-0.84; p=0.01). Conclusion In this cohort study of adults with SAB, comorbidities were associated with shorter symptom duration and an overall increased mortality risk. This study illustrates the importance of clinical management of comorbidities that increase patients’ for risk of infection and poor outcomes. Disclosures Vance G. Fowler, MD, MHS, Affinergy, Janssen, Contrafect: Advisor/Consultant|AstraZeneca; EDE; Basilea: Grant/Research Support|Debiopharm, GSK; Affinium, Basilea,: Advisor/Consultant|Destiny, Amphliphi, Armata, Akagera: Advisor/Consultant|Merck; Contrafect; Karius; Janssen: Grant/Research Support|UpToDate: Royalties|Valanbio: Stock options
Yan et al. (Thu,) studied this question.