Comparison of factors relating to management of SAB between UK and Vietnam/Nepal, and between UK centres.

1<p>Excludes 22 patients missing information on whether had an echocardiogram.</p>2<p>Excludes 29 patients missing information on active anti-staphylococcal antibiotic treatment, and 2 patients missing date started treatment.</p>3<p>Based on 429 patients with duration of treatment recorded, excluding those who died on treatment or within 2 days of stopping therapy.</p>4<p>Excludes 6 patients known to have been treated but were missing information on whether received combination therapy.</p>5<p>217/223 patients in the UK with removable focus had information on whether focus was removed, and if removed, date of removal recorded. Information on whether focus was removed was available for 7 of the 9 patients in Vietnam/Nepal with removable focus, with focus removed within 2 days of positive culture in 4 patients.</p>6<p>Excludes 1 UK centre with 3 patients enrolled.</p

Duration on any therapy and proportion of time treated spent on oral therapy exclusively (N = 429¹).

<p>¹ Excludes patients who died on therapy or within 2 days of stopping.</p

Antibiotics given for the treatment of SAB at any time during treatment, including early empirical treatment (N = 578¹).

1<p>Excludes 15/593 patients known to have been treated but information missing on antibiotics received (n = 10) or susceptibility to methicillin (n = 5, all received flucloxacillin).</p>2<p>Of 578 with information on antibiotics received, between 1–4 had missing information on whether they received an antibiotic. Antibiotics other than those listed were given to 81/578 (15%) patients. The most commonly used were a fluoroquinolone (n = 28, 5%) and doxycycline (n = 12, 2%). Daptomycin and tigecycline were used once.</p>3<p>The 4 patients not treated with vancomycin either died (n = 1) or were discharged (n = 3) within 24 hours of the positive blood culture.</p

Cumulative incidence of in-patient mortality from date of positive blood culture, by focus of infection.

<p>X-axis truncated at 60 days since there were only 4 deaths occurring after this time point.</p

Combinations of antibiotics received by patients with MRSA and MSSA bacteremia at any time during treatment (N = 274¹).

1<p>Information on whether combination therapy was used was available for 587 of the 593 patients who were treated, of whom 279 (48%) received combination therapy. Of these, 274 had information on susceptibility to methicillin.</p>2<p>72/274 (26%) of patients received more than one type of combination during the same episode.</p>3<p>Information on whether a given combination was used was missing for 2–3 patients for each combination listed.</p>4<p>112 received another 2-drug combination; 13 received 3 or more drugs in combination. Of the 112 who received a 2-drug combination 34 received a glycopeptide + beta-lactam, 12 received a beta-lactam + fluoroquinolone, 12 received a beta-lactam + clindamycin, and 7 received a beta-lactam + macrolide. The remaining 47 received one of 22 different combinations.</p

Baseline factors associated with inpatient mortality following positive blood culture.

1<p>Hazard ratios of inpatient mortality were estimated using competing risks method, with hospital discharge a competing risk. Missing data for covariates were imputed using multiple imputation chained equation methods.</p

Strength of association between predictors and poor outcome in the Dutch (original nomogram), Malawi, and Vietnamese population.

a<p>Odds ratios (OR) are calculated in 10-year increments for age; P1 denotes P-value for comparison between Dutch and Vietnamese cohorts; P2 denotes P-value for comparison between Dutch and Malawian cohorts.</p><p>Original beta's in the Dutch cohort were: intercept = −0.54; age per 1 year = 0.022; increased heart rate = 1.09; Glasgow Coma Scale score = −0.13; cranial nerve palsy = 0.91; CSF low white cell count = 1.37; gram+ = reference; gram- = −1.29; gram other = −1.04; gram negative = −1.09 The reference category for Gram's stain has been changed in comparison with the original publication.</p

Characteristics of adults with bacterial meningitis in the Netherlands, Vietnam, and Malawi.

<p>Numbers are number/number assessed (percentage) or mean ± standard deviation unless otherwise indicated. Median risk score refers to risk score published in reference <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0034311#pone.0034311-vandeBeek2" target="_blank">[3]</a>, P1 denotes P-value for comparison between Dutch and Vietnamese cohorts, P2 denotes P-value for comparison between Dutch and Malawian cohorts, HIV denotes human immunodeficiency virus, BP blood pressure, GCS Glasgow Coma Scale, GOS Glasgow Outcome Scale, mRS modified Ranking Scale, CSF cerebrospinal fluid, WBC white blood cells. * any cranial nerve palsy except VIII.</p

Predicted and observed percentage of patients with an unfavorable outcome across the range of predicted risk scores in the validation cohorts for Vietnam and Malawi.

<p>Predicted and observed percentage of patients with an unfavorable outcome across the range of predicted risk scores in the validation cohorts for Vietnam and Malawi.</p

SNP distances for Thai and global collection isolates.

<p>SNP distance between post-vaccine Thai isolates and their closest pre-vaccine Thai and post-vaccine global collection relatives, colored points indicate country of origin.</p