University of Maryland Baltimore, Baltimore, MD 21201, USA.
Diagn Microbiol Infect Dis. 2011 Jul;70(3):285-90. doi: 10.1016/j.diagmicrobio.2011.03.010. Epub 2011 May 10.
USA300 methicillin-resistant Staphylococcus aureus (MRSA) is increasing as a cause of severe community-associated bacteremic infections. We assessed severe sepsis in response to infection in patients with USA300 MRSA compared to non-USA300 MRSA bacteremia. A cohort study was conducted from 1997 to 2008 comparing sepsis in response to infection in 271 patients with MRSA bacteremia from 4 VA hospitals. Sixty-seven (25%) patients with MRSA bacteremia were USA300 MRSA; 204 (75%) were non-USA300 MRSA. The proportion of MRSA bacteremia caused by USA300 MRSA increased over time (χ² P < 0.0001). Adjusting for age and nosocomial infection, patients with USA300 MRSA bacteremia were more likely to have severe sepsis or septic shock in response to infection than patients with non-USA300 MRSA bacteremia (adjusted relative risk = 1.82; 95% confidence interval, 1.16-2.87; P = 0.01). This suggests that patients with USA300 MRSA are more likely to develop severe sepsis in response to their infection, which could be due to host or bacterial differences.
美国 300 型耐甲氧西林金黄色葡萄球菌（MRSA）是严重社区相关性菌血症感染的一个日益增多的原因。我们评估了美国 300 型 MRSA 感染患者的严重败血症反应与非美国 300 型 MRSA 菌血症的比较。这项队列研究在 1997 年至 2008 年期间，比较了来自 4 家退伍军人事务部医院的 271 例 MRSA 菌血症患者的感染后败血症。67 例（25%）MRSA 菌血症患者为美国 300 型 MRSA；204 例（75%）为非美国 300 型 MRSA。美国 300 型 MRSA 引起的 MRSA 菌血症比例随时间增加（X² P < 0.0001）。调整年龄和医院获得性感染因素后，美国 300 型 MRSA 菌血症患者的感染后严重败血症或感染性休克的可能性大于非美国 300 型 MRSA 菌血症患者（校正相对风险=1.82；95%置信区间，1.16-2.87；P = 0.01）。这表明，美国 300 型 MRSA 患者更有可能在感染后发生严重败血症，这可能是由于宿主或细菌差异所致。
