{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:05:59Z","timestamp":1780635959496,"version":"3.54.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    bloodstream infection (SAB) carries a high mortality rate. This study aims to develop a source-specific classification framework to guide management and improve outcomes.\n                  <\/jats:p>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective study of 321\n                      <jats:italic>S. aureus<\/jats:italic>\n                      bloodstream infection patients (2012-2025), using ROC analysis, survival curves, and SPSS to evaluate 12-month in-hospital mortality and its predictors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 3,516 bloodstream infections, 321 episodes of\n                      <jats:italic>S. aureus<\/jats:italic>\n                      bacteremia (SAB) were identified (9.12%). The median time to positivity was 14 hours. The most common infection sources were the lungs (26.8%), catheter-related infections (24.3%), and skin\/soft tissue infections (23.4%). Hemodialysis was the predominant comorbidity (21.2%). Biomarker analysis showed high diagnostic accuracy for PCT (AUC 0.957), WBC (AUC 1.000), and neutrophil percentage (AUC 0.913). MRSA accounted for 38% of isolates. Both MRSA and MSSA exhibited &amp;gt;50% resistance to penicillin, erythromycin, and clindamycin, but none to linezolid, vancomycin, or tigecycline. Overall, in-hospital mortality was 30.2%, significantly higher in MRSA (38%) than in MSSA (26%) (p=0.048). Notably, 36.1% of deaths occurred within 24 hours, and 58.7% within 7 days. The 10-day survival rate was lower in MRSA (0.609 vs. 0.759, p=0.029). Healthcare-associated infections (58%) showed no significant association with MRSA prevalence after Bonferroni correction. Independent mortality predictors included qSOFA score \u22652 (OR 3.450, 95% CI 1.835-6.835, p&amp;lt;0.001), age \u226560 years (OR 2.654, 95% CI 1.628-4.327, p&amp;lt;0.001), pulmonary source of BSI (OR 2.362, 95% CI 1.407-3.963, p&amp;lt;0.001), neutrophil percentage \u226589.60% (OR 2.195, 95% CI 1.294-3.720, p=0.003), procalcitonin \u22651.84 ng\/mL (OR 2.152, 95% CI 1.210-3.824, p=0.008), ineffective or no antibiotic use (OR 2.359, 95% CI 1.176-4.730, p=0.008), and MRSA infection (OR 1.756, 95% CI 1.081-2.853, p=0.023).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study establishes high-accuracy biomarkers (PCT\/WBC) and key mortality predictors for\n                      <jats:italic>S. aureus<\/jats:italic>\n                      BSIs, including MRSA infection, qSOFA\u22652, and ineffective antibiotics. These findings enable early risk stratification and emphasize the source-specific classification for prompt, appropriate antimicrobial therapy to improve clinical outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1790382","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:50:06Z","timestamp":1780635006000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk stratification and source classification in Staphylococcus aureus bloodstream infections: high mortality linked to mrsa, biomarkers, and treatment efficacy"],"prefix":"10.3389","volume":"17","author":[{"given":"Qiangsheng","family":"Feng","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, The 940th Hospital of Joint Logistics Support Force of People\u2019s Liberation Army","place":["Lanzhou, 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