Cosgrove Sara E, Sakoulas George, Perencevich Eli N, Schwaber Mitchell J, Karchmer Adolf W, Carmeli Yehuda
Division of Infectious Diseases, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts, USA.
Clin Infect Dis. 2003 Jan 1;36(1):53-9. doi: 10.1086/345476. Epub 2002 Dec 13.
A meta-analysis was performed to summarize the impact of methicillin-resistance on mortality in Staphylococcus aureus bacteremia. A search of the MEDLINE database for studies published during the period of 1 January 1980 through 31 December 2000 and a bibliographic review identified English-language studies of S. aureus bacteremia. Studies were included if they contained the numbers of and mortality rates for patients with methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) bacteremia. Data were extracted on demographic characteristics of the patients, adjustment for severity and comorbid illness, source of bacteremia, and crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for in-hospital mortality. When the results were pooled with a random-effects model, a significant increase in mortality associated with MRSA bacteremia was evident (OR, 1.93; 95% CI, 1.54-2.42; P<.001); significant heterogeneity was present. We explored the reasons for heterogeneity by means of subgroup analyses. MRSA bacteremia is associated with significantly higher mortality rate than is MSSA bacteremia.
进行了一项荟萃分析，以总结耐甲氧西林对金黄色葡萄球菌菌血症死亡率的影响。检索MEDLINE数据库中1980年1月1日至2000年12月31日期间发表的研究，并进行文献综述，以确定关于金黄色葡萄球菌菌血症的英文研究。如果研究包含耐甲氧西林金黄色葡萄球菌（MRSA）和甲氧西林敏感金黄色葡萄球菌（MSSA）菌血症患者的数量和死亡率，则纳入研究。提取了患者的人口统计学特征、病情严重程度和合并症的调整、菌血症来源以及住院死亡率的粗比值比（OR）和调整后比值比以及95%置信区间（CI）的数据。当结果用随机效应模型汇总时，与MRSA菌血症相关的死亡率显著增加（OR，1.93；95%CI，1.54 - 2.42；P <.001）；存在显著异质性。我们通过亚组分析探讨了异质性的原因。MRSA菌血症的死亡率显著高于MSSA菌血症。
