Austin Centre for Infection Research, Department of Infectious Diseases, Austin Health, Heidelberg, Vic., Australia; Department of Medicine, University of Melbourne, Parkville, Vic., Australia.
Clin Microbiol Infect. 2013 Dec;19(12):1163-8. doi: 10.1111/1469-0691.12168. Epub 2013 Feb 26.
We reported an association between elevated vancomycin MIC and 30-day mortality in patients with Staphylococcus aureus bacteraemia (SAB), including patients with methicillin-susceptible S. aureus (MSSA) treated with flucloxacillin. A detailed analysis of comorbidities and disease severity scores in the same cohort of patients was performed to ascertain if unknown clinical parameters may have influenced these results. The association between elevated vancomycin MIC and 30-day mortality in SAB remained significant (p 0.001) on multivariable logistic regression analysis even when accounting for clinical factors. In addition, the association persisted when restricting analysis to patients with MSSA bacteraemia treated with flucloxacillin. This suggests that elevated vancomycin MIC is associated with but not causally linked to an organism factor that is responsible for increased mortality.
我们报道了金黄色葡萄球菌菌血症（SAB）患者中万古霉素 MIC 升高与 30 天死亡率之间的关联，包括接受氟氯西林治疗的耐甲氧西林金黄色葡萄球菌（MSSA）患者。对同一患者队列中的合并症和疾病严重程度评分进行了详细分析，以确定未知的临床参数是否可能影响这些结果。即使在考虑临床因素的情况下，万古霉素 MIC 升高与 SAB 30 天死亡率之间的关联在多变量逻辑回归分析中仍然具有统计学意义（p<0.001）。此外，当将分析限制在接受氟氯西林治疗的 MSSA 菌血症患者时，这种关联仍然存在。这表明，万古霉素 MIC 升高与但不是因果关系与导致死亡率增加的生物体因素有关。
