Kitaya Shiori, Kanamori Hajime, Katori Yukio, Tokuda Koichi
Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan.
Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan.
Antibiotics (Basel). 2023 Feb 24;12(3):454. doi: 10.3390/antibiotics12030454.
Clinical outcomes of persistent staphylococcal bacteremia vary depending on the causative organism. This secondary data analysis study compared the clinical characteristics of persistent ()- and coagulase-negative staphylococci (CoNS)-caused bacteremia, focusing on the methicillin-resistant status. This study used data collected from patients who underwent blood cultures between January 2012 and December 2021 at Tohoku University Hospital, Japan. Patients with persistent staphylococcal bacteremia were divided into groups based on the pathogen and methicillin-resistant status, and their characteristics were analyzed. The primary outcomes were early (30-day), late (30-90 days), and 90-day mortality rates. The early, late, and 90-day mortality rates were similar between the persistent CoNS and bacteremia groups. Patients with persistent methicillin-resistant (MRSA) bacteremia tended to have higher early, late, and 90-day mortality rates than those with persistent methicillin-susceptible bacteremia (not statistically significant). No differences were observed between the methicillin-resistant and-susceptible CoNS groups. In patients with persistent CoNS bacteremia, mortality tended to increase, especially in debilitated or immunocompromised patients with distant metastases, underscoring the importance of infection source control. Mortality tended to be high in patients with persistent MRSA bacteremia, especially when persistent bacteremia clearance was not confirmed, illustrating the need for careful therapeutic management.
持续性葡萄球菌菌血症的临床结局因致病微生物而异。这项二次数据分析研究比较了由金黄色葡萄球菌和凝固酶阴性葡萄球菌(CoNS)引起的持续性菌血症的临床特征,重点关注耐甲氧西林状态。本研究使用了2012年1月至2021年12月在日本东北大学医院接受血培养的患者的数据。持续性葡萄球菌菌血症患者根据病原体和耐甲氧西林状态分组,并分析其特征。主要结局为早期(30天)、晚期(30 - 90天)和90天死亡率。持续性CoNS菌血症组和金黄色葡萄球菌菌血症组的早期、晚期和90天死亡率相似。持续性耐甲氧西林金黄色葡萄球菌(MRSA)菌血症患者的早期、晚期和90天死亡率往往高于持续性甲氧西林敏感金黄色葡萄球菌菌血症患者(无统计学意义)。耐甲氧西林和甲氧西林敏感的CoNS组之间未观察到差异。在持续性CoNS菌血症患者中,死亡率往往会增加,尤其是在有远处转移的虚弱或免疫功能低下患者中,这突出了感染源控制的重要性。持续性MRSA菌血症患者的死亡率往往较高,尤其是在未确认持续性菌血症清除的情况下,这说明需要进行仔细的治疗管理。