Mylotte J M, Tayara A
Division of Infectious Diseases, Department of Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Erie County Medical Center, Buffalo, NY 14215, USA.
Clin Infect Dis. 2000 Nov;31(5):1170-4. doi: 10.1086/317421. Epub 2000 Nov 7.
We performed a retrospective study of a large cohort of patients who had episodes of Staphylococcus aureus bacteremia (SAB) from January 1995 through February 1999 at 1 medical center to identify predictors of 30-day mortality in SAB. Among 293 patients with episodes of SAB, 68 died (23.2%) within 30 days of onset. There was no significant difference in 30-day mortality associated with treatment with vancomycin, a beta-lactam, or a miscellaneous group of antimicrobial agents (P=.180). By logistic regression, an acute physiology score (a component of the acute physiology and chronic health evaluation [APACHE III]) >60 at onset of SAB was the most important predictor of 30-day mortality (odds ratio [OR], 15.7). Other significant predictors were lung (OR, 5.8) or unknown (OR, 4.1) focus of SAB, age > or =65 years (OR, 2.0), and diabetes mellitus (OR, 2.4). Future investigators of SAB should take into consideration acute severity of illness at onset as well as other factors when evaluating or comparing outcomes.
我们对1995年1月至1999年2月期间在1个医疗中心发生金黄色葡萄球菌菌血症（SAB）发作的一大群患者进行了一项回顾性研究，以确定SAB患者30天死亡率的预测因素。在293例发生SAB的患者中，68例（23.2%）在发病后30天内死亡。使用万古霉素、β-内酰胺类药物或其他各类抗菌药物进行治疗，其30天死亡率无显著差异（P = 0.180）。通过逻辑回归分析，SAB发病时急性生理学评分（急性生理学与慢性健康状况评估[APACHE III]的一个组成部分）>60是30天死亡率的最重要预测因素（比值比[OR]，15.7）。其他显著的预测因素包括SAB的肺部（OR，5.8）或不明（OR，4.1）感染源、年龄≥65岁（OR，2.0）以及糖尿病（OR，2.4）。未来SAB的研究人员在评估或比较结果时应考虑发病时疾病的急性严重程度以及其他因素。
