Whitby M, McLaws M L, Berry G
Infection Management Services, Princess Alexandra Hospital, Brisbane, QLD.
Med J Aust. 2001 Sep 3;175(5):264-7. doi: 10.5694/j.1326-5377.2001.tb143562.x.
To estimate the risk of death from healthcare-associated (nosocomial) bacteraemia caused by methicillin-resistant Staphylococcus aureus (MRSA), and compare it with that of nosocomial bacteraemia caused by methicillin-sensitive S. aureus (MSSA), by meta-analysis of selected studies.
Medline, EMBASE, Current Contents and Cochrane Library were searched for the period January 1978 (or earliest date of the database, if later than 1978) to December 2000.
Studies which compared mortality of nosocomial MRSA and MSSA bacteraemia.
Nine studies were analysed. All but one found an increased relative risk (RR) of death from MRSA bacteraemia, with RR ranging from 0.89 to 4.94. Meta-analysis showed that patients with MRSA bacteraemia have an RR of death, compared with patients with MSSA bacteraemia, of 2.12 (95% CI, 1.76-2.57) using the fixed-effect method, and 2.03 (95% CI, 1.55-2.65) using the random-effect method.
MRSA bacteraemia is associated with a real increase in risk of death, further justifying ongoing MRSA surveillance and control in healthcare facilities.
通过对所选研究进行荟萃分析，评估耐甲氧西林金黄色葡萄球菌（MRSA）引起的医疗保健相关（医院内）菌血症导致的死亡风险，并将其与甲氧西林敏感金黄色葡萄球菌（MSSA）引起的医院内菌血症的死亡风险进行比较。
检索了1978年1月（或数据库最早日期，若晚于1978年）至2000年12月期间的Medline、EMBASE、《现刊目次》和Cochrane图书馆。
比较医院内MRSA和MSSA菌血症死亡率的研究。
分析了9项研究。除1项研究外，所有研究均发现MRSA菌血症导致的死亡相对风险（RR）增加，RR范围为0.89至4.94。荟萃分析显示，使用固定效应法，与MSSA菌血症患者相比，MRSA菌血症患者的死亡RR为2.12（95%可信区间，1.76 - 2.57）；使用随机效应法，RR为2.03（95%可信区间，1.55 - 2.65）。
MRSA菌血症与实际死亡风险增加相关，这进一步证明了在医疗机构中持续进行MRSA监测和控制的合理性。
