比较耐甲氧西林金黄色葡萄球菌与甲氧西林敏感金黄色葡萄球菌感染性心内膜炎的死亡率、卒中和复发情况：一项回顾性队列研究。
Comparison of mortality, stroke, and relapse for methicillin-resistant versus methicillin-susceptible Staphylococcus aureus infective endocarditis: a retrospective cohort study.
机构信息
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
出版信息
Diagn Microbiol Infect Dis. 2021 Aug;100(4):115395. doi: 10.1016/j.diagmicrobio.2021.115395. Epub 2021 Apr 17.
The purpose of this study was to compare survival, relapse, and stroke for patients with methicillin-resistant Staphylococcus aureus (MRSA) vs methicillin-susceptible S. aureus (MSSA) infective endocarditis (IE). In this retrospective study, the primary outcome of death and secondary outcomes of stroke and relapse were compared using multivariable Cox proportional hazards regression. Surgical treatment was adjusted for as a time-dependent variable. In total, 355 patients with at least one episode of IE caused by S. aureus were included. Patients with MRSA IE had higher mortality than those with MSSA IE (HR 1.34, 95% CI 1.01-1.77), but did not have a higher risk of stroke (HR 0.75, 95% CI 0.43-1.32) or relapse (HR 0.89, 95% CI 0.26-3.05). The cumulative incidence of relapse was very small. Among patients with IE caused by S. aureus MRSA infection is associated with higher mortality than MSSA infection.
本研究旨在比较耐甲氧西林金黄色葡萄球菌（MRSA）与甲氧西林敏感金黄色葡萄球菌（MSSA）感染性心内膜炎（IE）患者的生存率、复发率和卒中情况。在这项回顾性研究中，使用多变量 Cox 比例风险回归比较了死亡这一首要结局和卒中与复发这两个次要结局。手术治疗被调整为一个时变变量。共纳入了 355 例至少发生过一次由金黄色葡萄球菌引起的 IE 的患者。MRSA IE 患者的死亡率高于 MSSA IE 患者（HR 1.34，95%CI 1.01-1.77），但卒中风险（HR 0.75，95%CI 0.43-1.32）或复发风险（HR 0.89，95%CI 0.26-3.05）无差异。复发的累积发生率非常低。在由金黄色葡萄球菌引起的 IE 患者中，MRSA 感染与 MSSA 感染相比，死亡率更高。
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