Initial resuscitation and infection issues in a resource-limited setting.

<p>Initial resuscitation and infection issues in a resource-limited setting.</p

Association between clinical presentation and presence of Panton-Valentine Leukocidin (PVL) in the infecting isolate for 248 patients with <i>S. aureus</i> infection.

<p>Data are number (%). Denominator is the site of clinical presentation rather than patients.</p>*<p>¹p value for the comparison between PVL positive and PVL negative cases.</p>*<p>²Subset of respiratory infections with pneumonia.</p

Management and outcome of 72 patients with severe sepsis.

<p>When not shown the patient denominator is 72. Where the denominator differs from this for a particular question, these are shown.</p

Study flow diagram.

<p>Study flow diagram.</p

Other supportive therapy in a resource-limited setting.

<p>Other supportive therapy in a resource-limited setting.</p

Diagnostic criteria used for organ dysfunction.

<p>Criteria were from the literature <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0029858#pone.0029858-Bone1" target="_blank">[1]</a>, <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0029858#pone.0029858-Levy1" target="_blank">[2]</a>, <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0029858#pone.0029858-Goldstein1" target="_blank">[27]</a> to fit the available data. Acute oliguria was determined from 24-hour urine because hourly urine output was infrequently monitored. Diagnostic criteria of arterial hypoxaemia (PaO₂/FiO₂<300), ileus, and clinical signs of tissue hypoperfusion (decrease capillary refill or mottling) were not used as data were not recorded in the patient records. Laboratory testing for lactate level was not available in the hospital. The Glasgow Coma Score was not documented in patient records.</p

Hemodynamic support and adjunctive therapy of severe sepsis in a resource-limited setting.

<p>Hemodynamic support and adjunctive therapy of severe sepsis in a resource-limited setting.</p

Higher all-cause mortality associated with methicillin-resistant <i>S. aureus</i> (MRSA) but not with Panton-Valentine Leukocidin (PVL).

<p>Patients infected by MRSA had a greater all-cause mortality compared with patients infected by methicillin-susceptible <i>S. aureus</i> (MSSA) (p<0.001). Conversely, patients infected by PVL gene-positive <i>S. aureus</i> had a lower all-cause mortality compared with patients infected by PVL gene-negative <i>S. aureus</i> (p<0.001), an association that remained after adjustment for MRSA (p = 0.001).</p

Timely effective antibiotic therapy and procedures for infectious source control significantly improved outcome.

<p>Administration of an effective antibiotic on the same day as the positive culture was taken significantly reduced all-cause mortality (p<0.001), as did undergoing a procedure for infectious source control (p<0.001).</p

Association between patient characteristics and outcome for 270 patients with <i>S. aureus</i> infection.

<p>Data are number (%) unless otherwise stated.</p>*<p>¹p value for the comparison between all-cause deaths and survivors.</p>*<p>²Denominator for occupation is number of patients over the age of 16 years which is given in each square.</p>*<p>³Past medical history of any underlying chronic medical conditions reported by the patient/relative or recorded in the medical notes.</p>*<p>⁴Immunosuppression from HIV (5 untreated, 3 on anti-retroviral therapy), chemotherapy (n = 3), untreated leukaemia (n = 1), radiotherapy (n = 1) or immunosuppressive medication including prednisolone more than 30 mg/day for more than 1 week (n = 17).</p>*<p>⁵Renal disease included end stage renal failure on long-term dialysis (n = 3; 2 on haemodialysis, 1 on peritoneal dialysis) and chronic renal failure (not on dialysis) due to diabetes mellitus (n = 14), systemic lupus erythematosus (n = 1), multiple myeloma (n = 1), glomerulonephritis (n = 1) or an unknown aetiology (n = 5).</p>*<p>⁶Cardiac disease comprised congenital heart disease (n = 4), valvular heart disease including rheumatic heart disease (n = 8), ischaemic heart disease (n = 8), or arrhythmias including heart block requiring pacemaker (n = 4).</p>*<p>⁷Lung disease comprised previously treated tuberculosis (n = 9), previous empyema (n = 1), lung cancer (n = 2), long-term tracheostomy (n = 1), chronic obstructive pulmonary disease (n = 2) or asthma (n = 1).</p