Cooper G, Platt R
Am J Med. 1982 Nov;73(5):658-62. doi: 10.1016/0002-9343(82)90407-7.
The presentation and course of Staphylococcus aureus bacteremia in 27 diabetic patients (18 insulin-dependent) were compared with those in 34 nondiabetic patients. The groups were comparable in age, proportion with pre-existing cardiac valvular disease, community-acquired bacteremia, fever, and leukocytosis. Endocarditis (vegetation or new regurgitant murmur) was present in eight (30 percent) diabetics and four (12 percent) nondiabetics (p = 0.16). A primary focus of infection was present in 67 percent of diabetics and 65 percent of nondiabetics. Among those with a focus, six of 18 diabetics and none of 22 nondiabetics had endocarditis (p less than 0.005). Fifteen of 54 (28 percent) patients who received appropriate antibiotic therapy died. After stratificaton for underlying illness, there was no mortality difference between those with and without endocarditis (three endocarditis deaths versus 1.78 expected), or between those with and without diabetes (four diabetic deaths versus 4.8 expected). Diabetics with staphylococcal bacteremia were more likely than nondiabetics to have endocarditis in the presence of a primary focus. They had no increase in mortality.
对27例糖尿病患者（18例胰岛素依赖型）和34例非糖尿病患者金黄色葡萄球菌菌血症的表现及病程进行了比较。两组在年龄、原有心脏瓣膜疾病比例、社区获得性菌血症、发热及白细胞增多方面具有可比性。8例（30%）糖尿病患者和4例（12%）非糖尿病患者存在心内膜炎（赘生物或新出现的反流性杂音）（p = 0.16）。67%的糖尿病患者和65%的非糖尿病患者有感染的原发灶。在有原发灶的患者中，18例糖尿病患者中有6例发生心内膜炎，22例非糖尿病患者中无一例发生心内膜炎（p<0.005）。54例接受了适当抗生素治疗的患者中有15例（28%）死亡。在对基础疾病进行分层后，有心内膜炎和无心内膜炎患者之间（3例心内膜炎死亡，预期为1.78例）或有糖尿病和无糖尿病患者之间（4例糖尿病患者死亡，预期为4.8例）的死亡率无差异。有原发灶时，患金黄色葡萄球菌菌血症的糖尿病患者比非糖尿病患者更易发生心内膜炎。他们的死亡率没有增加。
