Combination therapy with an aminoglycoside for Staphylococcus aureus endocarditis and/or persistent bacteremia is associated with a decreased rate of recurrent bacteremia: a cohort study.
Combination therapy with an aminoglycoside for Staphylococcus aureus endocarditis and/or persistent bacteremia is associated with a decreased rate of recurrent bacteremia: a cohort study.
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与金黄色葡萄球菌心内膜炎和/或持续性菌血症的氨基糖苷结合疗法与复发性菌血症的降低有关：一项同伴研究。
DOI：
10.1007/s15010-011-0189-2
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发表时间：
2011-12
期刊：
影响因子：
7.5
通讯作者：
Amorosa, V. K.
中科院分区：
文献类型：
--
作者：
Lemonovich, T. L.;Haynes, K.;Lautenbach, E.;Amorosa, V. K.
尽管关于氨基糖苷类药物协同治疗持续性金黄色葡萄球菌菌血症和心内膜炎的疗效和潜在风险的数据有限，但氨基糖苷类药物在临床实践中经常使用。作为我们的研究人群，我们纳入了符合改良杜克标准的S。金黄色葡萄球菌心内膜炎和/或具有大于72小时的S.金黄色菌血症在这些受试者中，我们比较了接受和未接受氨基糖苷类药物治疗的S。金黄色葡萄球菌血流感染比较这些组的主要转归复发性菌血症，以及菌血症持续时间、死亡率、并发症发生率和肾衰竭事件。87例受试者符合入选标准。其中，49人接受了氨基糖苷类药物治疗，而38人没有。比较接受或未接受氨基糖苷类药物治疗的组，基线特征无显著差异。4例（8.2%）接受氨基糖苷类药物治疗的受试者发生复发性菌血症，而9例（23.7%）未接受氨基糖苷类药物治疗的受试者发生复发性菌血症[相对风险和95%置信区间[RR（95%CI）] = 0.51（0.22-1.17），p = 0.04]。在多变量分析中，氨基糖苷类药物的使用仍然与复发菌血症的减少显著相关[校正比值比（OR）（95%CI）= 0.26（0.07-0.98），p = 0.046]。在6个月全因死亡率（51.0 vs. 42.1%，p = 0.41）、并发症发生率（71.4 vs. 73.7%，p = 0.82）或肾衰竭事件发生率（54.5 vs. 46.9%，p = 0.54）方面，未观察到接受和未接受氨基糖苷类药物治疗组之间的显著差异。氨基糖甙类联合治疗持续性链球菌病的应用。金黄色葡萄球菌菌血症和/或心内膜炎可能与较低的菌血症复发率相关，但在肾衰竭发生率方面无显著差异。
Although limited data exist on the efficacy and potential risk of synergistic aminoglycoside therapy for persistent Staphylococcus aureus bacteremia and endocarditis, aminoglycosides are frequently used in clinical practice. As our study population, we included subjects fulfilling the modified Duke criteria for S. aureus endocarditis and/or having greater than 72 h of S. aureus bacteremia. Among these subjects, we compared patients who did and did not receive aminoglycoside therapy for their S. aureus bloodstream infection. These groups were comared for the primary outcome of recurrent bacteremia, as well as for the duration of bacteremia, mortality, complication rate, and incident renal failure. Eighty-seven subjects fulfilled the inclusion criteria. Of these, 49 received aminoglycoside therapy, whereas 38 did not. There were no significant differences in the baseline characteristics when comparing groups who did or did not receive aminoglycoside therapy. Four (8.2%) subjects treated with aminoglycoside therapy experienced recurrent bacteremia versus nine (23.7%) who did not receive aminoglycoside therapy [relative risk and 95% confidence interval [RR (95%CI)] = 0.51 (0.22–1.17), p = 0.04]. In multivariable analyses, aminoglycoside use remained significantly associated with a decrease in recurrent bacteremia [adjusted odds ratio (OR) (95%CI) = 0.26 (0.07–0.98), p = 0.046]. No significant differences were seen between groups treated with and without an aminoglycoside in terms of the 6-month all-cause mortality (51.0 vs. 42.1%, p = 0.41), complication rate (71.4 vs. 73.7%, p = 0.82), or incident renal failure (54.5 vs. 46.9%, p = 0.54). The use of combination therapy with an aminoglycoside in persistent S. aureus bacteremia and/or endocarditis may be associated with a lower rate of recurrent bacteremia without significant differences in the incident renal failure.
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影响因子：
11.8
作者：
Li, JS;Sexton, DJ;Corey, GR
通讯作者：
Corey, GR
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5.2
作者：
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