Staphylococcus aureus Bloodstream Infection and Endocarditis - A Prospective Cohort Study

{Objectives To update the epidemiology of Staphylococcus aureusbloodstream infection (SAB) in a high-income country and its link with infective endocarditis (IE). Methods All consecutive adult patients with incident SAB (n = 2008) were prospectively enrolled between 2009 and 2011 in 8 university hospitals in France. Results SAB was nosocomial in 54%, non-nosocomial healthcare related in 18% and communityacquired in 26%. Methicillin resistance was present in 19% of isolates. SAB Incidence of nosocomial SAB was 0.159/1000 patients-days of hospitalization (95% confidence interval [CI] 0.111-0.219). A deep focus of infection was detected in 37%, the two most frequent were IE (11%) and pneumonia (8%). The higher rates of IE were observed in injecting drug users (IE: 38%) and patients with prosthetic (IE: 33%) or native valve disease (IE: 20%) but 40% of IE occurred in patients without heart disease nor injecting drug use. IE was more frequent in case of community-acquired (IE: 21%, adjusted odds-ratio (aOR) = 2.9