Association of Daily Body Temperature, White Blood Cell Count, and C-reactive Protein With Mortality and Persistent Bacteremia in Patients With Staphylococcus Aureus Bacteremia: A Post Hoc Analysis of the CAMERA2 Randomized Clinical Trial - Summary - MDSpire

Association of Daily Body Temperature, White Blood Cell Count, and C-reactive Protein With Mortality and Persistent Bacteremia in Patients With Staphylococcus Aureus Bacteremia: A Post Hoc Analysis of the CAMERA2 Randomized Clinical Trial

  • By

  • Sean W X Ong

  • Nick Daneman

  • Joshua S Davis

  • Steven Y C Tong

  • for the Combination Antibiotics for MEthicillin Resistant Staphylococcus aureus (CAMERA2) Study Group

  • David C Lye

  • Dafna Yahav

  • Archana Sud

  • J Owen Robinson

  • Jane Nelson

  • Sophia Archuleta

  • Matthew A Roberts

  • Alan Cass

  • David L Paterson

  • Hong Foo

  • Mical Paul

  • Stephen D Guy

  • Adrian R Tramontana

  • Genevieve B Walls

  • Stephen McBride

  • Narin Bak

  • Niladri Ghosh

  • Benjamin A Rogers

  • Anna P Ralph

  • Jane Davies

  • Patricia E Ferguson

  • Ravindra Dotel

  • Genevieve L McKew

  • Timothy J Gray

  • Natasha E Holmes

  • Simon Smith

  • Morgyn S Warner

  • Shirin Kalimuddin

  • Barnaby E Young

  • Naomi Runnegar

  • David N Andresen

  • Nicholas A Anagnostou

  • Mark D Chatfield

  • Allen C Cheng

  • Vance G Fowler

  • Benjamin P Howden

  • Niamh Meagher

  • David J Price

  • Sebastiaan J van Hal

  • Matthew V N O Sullivan

  • January 30, 2025

  • 0 min

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Objective:

To evaluate the prognostic relevance of daily body temperature, white blood cell (WBC) levels, and C-reactive protein (CRP) in predicting 90-day mortality specifically in patients with methicillin-resistant Staphylococcus aureus bacteremia.

Key Findings:
  • Fever (body temperature ≥38.0 °C) was associated with increased odds of 90-day mortality from day 4 onwards, with adjusted odds ratios of 3.70 (95% CI) on day 4 and 8.78 (95% CI) on day 7.
  • Higher adjusted odds of mortality were observed with persistent fever on day 7 compared to day 4.
  • CRP and abnormal WBC counts did not show consistent or temporal associations with mortality.
Interpretation:

Persistent fever after 72 hours is a significant predictor of mortality in MRSA bacteremia patients, suggesting its utility in risk stratification and clinical decision-making.

Limitations:
  • The analysis is based on a post hoc evaluation, which may introduce biases affecting the reliability of the findings.
  • Limited predictive value of WBC and CRP levels for mortality was observed, indicating the need for further research.
Conclusion:

Daily body temperature is a crucial parameter for assessing mortality risk in MRSA bacteremia, while WBC and CRP levels provide limited additional predictive value, underscoring the need for focused clinical attention.

Original Source(s)

Association of Daily Body Temperature, White Blood Cell Count, and C-reactive Protein With Mortality and Persistent Bacteremia in Patients With Staphylococcus Aureus Bacteremia: A Post Hoc Analysis of the CAMERA2 Randomized Clinical Trial

  • by Sean W X Ong, Nick Daneman, Joshua S Davis, Steven Y C Tong, for the Combination Antibiotics for MEthicillin Resistant Staphylococcus aureus (CAMERA2) Study Group, David C Lye, Dafna Yahav, Archana Sud, J Owen Robinson, Jane Nelson, Sophia Archuleta, Matthew A Roberts, Alan Cass, David L Paterson, Hong Foo, Mical Paul, Stephen D Guy, Adrian R Tramontana, Genevieve B Walls, Stephen McBride, Narin Bak, Niladri Ghosh, Benjamin A Rogers, Anna P Ralph, Jane Davies, Patricia E Ferguson, Ravindra Dotel, Genevieve L McKew, Timothy J Gray, Natasha E Holmes, Simon Smith, Morgyn S Warner, Shirin Kalimuddin, Barnaby E Young, Naomi Runnegar, David N Andresen, Nicholas A Anagnostou, Mark D Chatfield, Allen C Cheng, Vance G Fowler, Benjamin P Howden, Niamh Meagher, David J Price, Sebastiaan J van Hal, Matthew V N O Sullivan

  • January 30, 2025

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