Eosinopenia Associated with Infection is an Independent Risk Factor for 28-day Mortality in Staphylococcus aureus Bloodstream Infection

Main Article Content

Chunxia Zhou
Jing Sun
Fengqin Xu
Shanping Jiang

Abstract

Aims: This retrospective study aimed to evaluate the impact of eosinopenia on 28-day mortality in Staphylococcus aureus bloodstream infection (SABSI). 

Methods:  A retrospective study was designed to evaluate the impact of eosinopenia on 28-day mortality in SABSI.

Results: Patients who were ≥16 years old with SABSI at Sun Yat-Sen Memorial Hospital between January 1st 2014 and December 31st 2018 were included. The overall 28-day mortality of all patients was 14.3% (44 out of 307). Patients with eosinopenia in the onset of SABSI had a significantly higher 28-day mortality than those without eosinopenia (22.4% vs 6.5%; P<0.01). For patients who developed SABSI after the first 48 hours in the hospital, eosinophils decreased significantly from the baseline (P<0.01). Kaplan–Meier survival curve showed that patients with eosinopenia had a lower survival rate than those without eosinopenia (P<0.01). Multivariate Cox regression analysis revealed that eosinophils in the onset of SABSI were associated independently with 28-day mortality (hazard ratio [HR], 2.84; 95% confidence interval [CI], 1.36–5.91; P<0.01).

Conclusion: Eosinopenia associated with infection might be an independent risk factor for 28-day mortality in SABSI.

Keywords:
Staphylococcus aureus, bloodstream infection, prognosis, eosinopenia.

Article Details

How to Cite
Zhou, C., Sun, J., Xu, F., & Jiang, S. (2019). Eosinopenia Associated with Infection is an Independent Risk Factor for 28-day Mortality in Staphylococcus aureus Bloodstream Infection. Asian Journal of Research in Infectious Diseases, 2(4), 1-9. https://doi.org/10.9734/ajrid/2019/v2i430114
Section
Original Research Article

References

Widmer AF, Lakatos B, Frei R. Strict infection control leads to low incidence of methicillin-resistant Staphylococcus aureus bloodstream infection over 20 years. Infect Control Hosp Epidemiol. 2015;36:702-709.

Kern WV. Management of Staphylococcus aureus bacteremia and endocarditis: Progresses and challenges. CURR OPIN INFECT DIS. 2010;23:346-358.

Taylor G, Bush K, Leal J, Henderson E, Chui L, Louie M: Epidemiology of meticillin-resistant Staphylococcus aureus bloodstream infections in Alberta, Canada. J HOSP INFECT. 2015;89:132-135.

Durnas B, Watek M, Wollny T, Niemirowicz K, Marzec M, Bucki R, Gozdz S. Utility of blood procalcitonin concentration in the management of cancer patients with infections. Onco Targets Ther. 2016;9:469-475.

Ozsurekci Y, Oktay AK, Bayhan C, Karadag-Oncel E, Emre AA, Gurbuz V, Hascelik G, Ceyhan M. Can procalcitonin be a diagnostic marker for catheter-related blood stream infection in children? J Pediatr (Rio J). 2016;92:414-420.

Guo SY, Zhou Y, Hu QF, Yao J, Wang H. Procalcitonin is a marker of gram-negative bacteremia in patients with sepsis. AM J MED SCI. 2015;349:499-504.

Cohen SG, Sapp TM. Phagocytosis of bacteria by eosinophils in infectious-related asthma. The Journal of Allergy. 1969;44:113.

Percopo CM, Dyer KD, Ochkur SI, Luo JL, Fischer ER, Lee JJ, Lee NA, Domachowske JB, Rosenberg HF. Activated mouse eosinophils protect against lethal respiratory virus infection. Blood. 2014;123:743-752.

Samarasinghe AE, Melo RC, Duan S, LeMessurier KS, Liedmann S, Surman SL, Lee JJ, Hurwitz JL, Thomas PG, McCullers JA. Eosinophils promote anti-viral immunity in mice infected with influenza a virus. J IMMUNOL. 2017;198: 3214-3226.

Chen HC, Lin WL, Lin CC, Hsieh WH, Hsieh CH, Wu MH, Wu JY, Lee CC. Outcome of inadequate empirical antibiotic therapy in emergency department patients with community-onset blood-stream infections. J Antimicrob Chemother. 2013;68:947-953.

Carranza-Rodriguez C, Escamilla-Gonzalez M, Fuentes-Corripio I, Perteguer-Prieto MJ, Garate-Ormaechea T, Perez-Arellano JL: [Helminthosis and eosinophilia in Spain (1990-2015)]. Enferm Infecc Microbiol Clin; 2016.

Yenigun A, Sezen S, Calim OF, Ozturan O. Evaluation of the eosinophil-to-lymphocyte ratio in pediatric patients with allergic rhinitis. AM J Rhinol Allergy. 2016; 30:21-25.

Fabre V, Beiting DP, Bliss SK, Gebreselassie NG, Gagliardo LF, Lee NA, Lee JJ, Appleton JA. Eosinophil deficiency compromises parasite survival in chronic nematode infection. J Immunol. 2009;182: 1577-1583.

Bass DA, Gonwa TA, Szejda P, Cousart MS, DeChatelet LR, McCall CE. Eosinopenia of acute infection: Production of eosinopenia by chemotactic factors of acute inflammation. J CLIN Invest. 1980; 65:1265-1271.

Hogan SP, Rosenberg HF, Moqbel R, Phipps S, Foster PS, Lacy P, Kay AB, Rothenberg ME. Eosinophils: Biological properties and role in health and disease. CLIN EXP Allergy. 2008;38: 709-750.

Bass DA. Behavior of eosinophil leuko-cytes in acute inflammation. II. Eosinophil dynamics during acute inflammation. J CLIN Invest. 1975;56:870-879.

Drake MG, Bivins-Smith ER, Proskocil BJ, Nie Z, Scott GD, Lee JJ, Lee NA, Fryer AD, Jacoby DB. Human and mouse eosinophils have antiviral activity against parainfluenza virus. Am J Resp Cell Mol. 2016;55:387-394.

Phipps S, Lam CE, Mahalingam S, Newhouse M, Ramirez R, Rosenberg HF, Foster PS, Matthaei KI. Eosinophils contribute to innate antiviral immunity and promote clearance of respiratory syncytial virus. Blood. 2007;110:1578-1586.

Ueki S, Melo RC, Ghiran I, Spencer LA, Dvorak AM, Weller PF. Eosinophil extracellular DNA trap cell death mediates lytic release of free secretion-competent eosinophil granules in humans. Blood. 2013;121:2074-2083.

Spreng M. Possible health effects of noise induced cortisol increase. Noise Health. 2000;2:59-64.

Levinson AT, Casserly BP, Levy MM. Reducing mortality in severe sepsis and septic shock. Semin Respir Crit Care Med. 2011;32:195-205.

Brohee D, Vanhaeverbeek M, Kennes B, Neve P. Leukocyte and lymphocyte subsets after a short pharmacological stress by intravenous epinephrine and hydrocortisone in healthy humans. INT J Neuro Sci. 1990;53:53-62.

Prince LR, Graham KJ, Connolly J, Anwar S, Ridley R, Sabroe I, Foster SJ, Whyte MK: Staphylococcus aureus induces eosinophil cell death mediated by alpha-hemolysin. Plos One. 2012;7:e31506.

Buonomo EL, Cowardin CA, Wilson MG, Saleh MM, Pramoonjago P, Petri WA. Microbiota-regulated IL-25 increases eosinophil number to provide 1 protection during Clostridium difficile infection. CELL REP. 2016;16:432-443.

Torrent M, de la Torre BG, Nogues VM, Andreu D, Boix E: Bactericidal and membrane disruption activities of the eosinophil cationic protein are largely retained in an N-terminal fragment. BIOCHEM J. 2009;421:425-434.

Driss V, Legrand F, Hermann E, Loiseau S, Guerardel Y, Kremer L, Adam E, Woerly G, Dombrowicz D, Capron M: TLR2-dependent eosinophil interactions with mycobacteria: Role of alpha-defensins. Blood. 2009;113:3235-3244.

Yousefi S, Gold JA, Andina N, Lee JJ, Kelly AM, Kozlowski E, Schmid I, Straumann A, Reichenbach J, Gleich GJ, Simon HU. Catapult-like release of mitoch-ondrial DNA by eosinophils contributes to antibacterial defense. NAT MED. 2008;14: 949-953.

Rodriguez-Fernandez A, Andaluz-Ojeda D, Almansa R, Justel M, Eiros JM, Ortiz DLR. Eosinophil as a protective cell in S. Aureus ventilator-associated pneumonia. Mediators Inflamm. 2013;152943.