Ohta Ryuichi, Sano Chiaki
Communiy Care, Unnan City Hospital, Unnan, JPN.
Community Medicine Management, Shimane University Faculty of Medicine, Izumo, JPN.
Cureus. 2024 Sep 24;16(9):e70120. doi: 10.7759/cureus.70120. eCollection 2024 Sep.
Introduction Staphylococcus aureus bacteremia (SAB) poses a significant health risk, particularly among adults over 65 years old, due to age-related vulnerabilities and comorbidities. Recurrent SAB is associated with increased morbidity, prolonged hospitalizations, and higher healthcare costs, necessitating the identification of risk factors that contribute to these recurrent infections. Methods A retrospective cohort study was conducted at a rural community hospital to identify factors associated with recurrent SAB in older patients. Data were extracted from electronic medical records of patients diagnosed with SAB between April 2016 and December 2023. Multivariate logistic regression was employed to analyze the relationship between recurrent SAB and potential risk factors, including age, sex, BMI, dependency on Japanese long-term health insurance, and comorbidities. Results Among 99 patients with SAB, 36 (36.4%) experienced recurrence. Higher BMI was significantly associated with recurrent SAB (OR: 1.15, 95% CI: 1.01-1.31, p = 0.036), while dependency on long-term care was associated with a lower risk of recurrence (OR: 0.20, 95% CI: 0.06-0.64, p = 0.007). Age and sex did not show significant associations with recurrence. Conclusion This study identified higher BMI as a risk factor for recurrent SAB in older patients, while dependency on long-term care was protective. These findings highlight the need for targeted management strategies for patients with higher BMI to prevent recurrent SAB. Further research is needed to explore these associations and confirm their relevance in other clinical settings.
引言 金黄色葡萄球菌菌血症（SAB）构成重大健康风险，尤其在65岁以上成年人中，原因是与年龄相关的脆弱性和合并症。复发性SAB与发病率增加、住院时间延长及医疗费用升高相关，因此有必要确定导致这些复发性感染的风险因素。方法 在一家农村社区医院开展一项回顾性队列研究，以确定老年患者复发性SAB的相关因素。数据从2016年4月至2023年12月期间诊断为SAB的患者电子病历中提取。采用多因素逻辑回归分析复发性SAB与潜在风险因素之间的关系，这些因素包括年龄、性别、体重指数（BMI）、对日本长期健康保险的依赖程度以及合并症。结果 在99例SAB患者中，36例（36.4%）出现复发。较高的BMI与复发性SAB显著相关（比值比：1.15，95%置信区间：1.01 - 1.31，p = 0.036），而对长期护理的依赖与较低的复发风险相关（比值比：0.20，95%置信区间：0.06 - 0.64，p = 0.007）。年龄和性别与复发无显著关联。结论 本研究确定较高的BMI是老年患者复发性SAB的一个风险因素，而对长期护理的依赖具有保护作用。这些发现凸显了对BMI较高的患者采取针对性管理策略以预防复发性SAB的必要性。需要进一步研究来探索这些关联并证实它们在其他临床环境中的相关性。
