Austin Thomas W, Austin Marilyn A, Coleman Brenda
London Health Sciences Center, London, Ontario, Canada.
Saudi Med J. 2003 Mar;24(3):256-60.
To examine the differences between the clinical presentation, management and outcome of persons bacteremic with methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA), after controlling for age, sex and primary diagnosis.
A review of the clinical records and laboratory data of all MRSA and MSSA bacteremic patients. Fifty matched case-control pairs were further analyzed looking for differences between the 2 populations. The study was carried out in a 500-bed adult tertiary care institution in southwestern Ontario, Canada, between 1994 and 1999.
On univariate analysis a) duration of hospitalization prior to bacteremia, b) concomitant polymicrobial bacteremia, c) time to appropriate treatment, were significantly greater in the MRSA infected population. Attributable mortality was also higher, 36%-20%, but this did not achieve significance (p=0.1). On multiple logistic regression analysis, a), b) and c) remained significantly different.
In a 1:1 matched case-control study of Staphylococcus aureus bacteremia, those infected with MRSA became bacteremic later in their hospital stay, more often had a polymicrobial bacteremia and were appropriately treated later. Although mortality attributable to the MRSA bacteremia was greater, this difference did not achieve significance.
在控制年龄、性别和初步诊断因素后，研究耐甲氧西林金黄色葡萄球菌（MRSA）菌血症患者与甲氧西林敏感金黄色葡萄球菌（MSSA）菌血症患者在临床表现、治疗及预后方面的差异。
回顾所有MRSA和MSSA菌血症患者的临床记录和实验室数据。进一步分析50对匹配的病例对照，寻找这两组人群之间的差异。该研究于1994年至1999年在加拿大安大略省西南部一家拥有500张床位的成人三级医疗机构中进行。
单因素分析显示，a）菌血症发生前的住院时间、b）合并多种微生物菌血症、c）开始适当治疗的时间，在MRSA感染人群中显著更长。归因死亡率也更高，为36%-20%，但未达到统计学显著性（p=0.1）。多因素逻辑回归分析显示，a）、b）和c）仍存在显著差异。
在一项1:1匹配的金黄色葡萄球菌菌血症病例对照研究中，感染MRSA的患者在住院后期发生菌血症，更常合并多种微生物菌血症，且开始适当治疗的时间更晚。虽然MRSA菌血症导致的死亡率更高，但这一差异未达到统计学显著性。
