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有可根除病灶与无可根除病灶的金黄色葡萄球菌菌血症患者的结局

Outcome of Staphylococcus aureus bacteremia in patients with eradicable foci versus noneradicable foci.

作者信息

Kim Sung-Han, Park Wan-Bum, Lee Ki-Deok, Kang Cheol-In, Kim Hong-Bin, Oh Myoung-don, Kim Eui-Chong, Choe Kang-Won

机构信息

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.

出版信息

Clin Infect Dis. 2003 Sep 15;37(6):794-9. doi: 10.1086/377540. Epub 2003 Aug 23.

Abstract

To determine the outcome of Staphylococcus aureus bacteremia (SAB) on mortality, including the impact of methicillin resistance and an initial delay (< or =48 h) of appropriate antibiotics, a retrospective cohort study including 238 patients with SAB was performed. By logistic regression, noneradicable or noneradicated foci, underlying cirrhosis, and cancer were found to be independent predictors of mortality. In patients with eradicable foci, there were no significant differences in the associated mortality rate between methicillin-resistant SAB (11%) and methicillin-susceptible SAB (13%), and between inappropriate (13%) and appropriate (10%) empirical therapy, respectively (P=.79 and P=.78, respectively). By logistic regression, it was found that, in the subgroup of patients with noneradicable foci, underlying cirrhosis (odds ratio [OR], 3.1) and methicillin-resistant SAB (OR, 2.4) were independently associated with mortality.

摘要

为了确定金黄色葡萄球菌菌血症(SAB)对死亡率的影响,包括耐甲氧西林情况以及适当抗生素初始延迟(≤48小时)的影响,我们进行了一项回顾性队列研究,纳入了238例SAB患者。通过逻辑回归分析,发现不可根除或未根除的病灶、潜在肝硬化和癌症是死亡率的独立预测因素。在有可根除病灶的患者中,耐甲氧西林SAB(11%)和甲氧西林敏感SAB(13%)之间,以及不适当经验性治疗组(13%)和适当经验性治疗组(10%)之间的相关死亡率无显著差异(P值分别为0.79和0.78)。通过逻辑回归分析发现,在有不可根除病灶的患者亚组中,潜在肝硬化(比值比[OR],3.1)和耐甲氧西林SAB(OR,2.4)与死亡率独立相关。

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