Laupland Kevin B, Harris Patrick N A, Stewart Adam G, Edwards Felicity, Paterson David L
Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia; Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
University of Queensland, Faculty of Medicine, UQ Center for Clinical Research, Brisbane, Australia; Department of Microbiology, Pathology Queensland, Brisbane, Australia.
Diagn Microbiol Infect Dis. 2022 Nov;104(3):115772. doi: 10.1016/j.diagmicrobio.2022.115772. Epub 2022 Jul 22.
The objective of this study was to examine the occurrence, determinants, and outcome of S. aureus bloodstream infections (BSI) diagnosed based on single versus multiple positive initial cultures.
All adults with first episodes of mono-microbial S. aureus BSI in Queensland during 2000-2019 were included.
10,855 (67%) and 5,421 (33%) were diagnosed based on one and multiple positive initial cultures, respectively. Patients with multiple positive initial cultures were significantly younger, more likely to have community-associated disease, have a shorter time to culture positivity, less likely to have methicillin-resistant S. aureus BSI, and have a different distribution of comorbid medical illnesses and clinical foci. The 30-day all-cause case-fatality rate was 18% and single positive initial culture was an independent risk factor for death.
Among patients with S. aureus BSI, those diagnosed by single positive initial blood cultures have different clinical features and a higher risk for death.
本研究的目的是检查基于单次与多次阳性初始培养诊断的金黄色葡萄球菌血流感染（BSI）的发生率、决定因素和结局。
纳入2000年至2019年期间在昆士兰州首次发生单微生物金黄色葡萄球菌BSI的所有成年人。
分别基于一次和多次阳性初始培养诊断出10855例（67%）和5421例（33%）。多次阳性初始培养的患者明显更年轻，更有可能患有社区相关疾病，培养阳性时间更短，耐甲氧西林金黄色葡萄球菌BSI的可能性更小，并且合并内科疾病和临床病灶的分布不同。30天全因病死率为18%，单次阳性初始培养是死亡的独立危险因素。
在金黄色葡萄球菌BSI患者中，通过单次阳性初始血培养诊断的患者具有不同的临床特征和更高的死亡风险。
