Association Between Vancomycin Minimum Inhibitory Concentration and Mortality Among Patients With Staphylococcus aureus Bloodstream Infections A Systematic Review and Meta-analysis
Association Between Vancomycin Minimum Inhibitory Concentration and Mortality Among Patients With Staphylococcus aureus Bloodstream Infections A Systematic Review and Meta-analysis
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DOI：
10.1001/jama.2014.6364
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发表时间：
2014-10-15
影响因子：
120.7
通讯作者：
Rupp, Mark E.
中科院分区：
文献类型：
--
作者：
Kalil, Andre C.;Van Schooneveld, Trevor C.;Rupp, Mark E.
重要性金黄色葡萄球菌菌血症（SAB）是一个世界性的问题。目前尚不清楚较高的万古霉素最低抑菌浓度（MIC）是否与死亡率相关。数据来源PubMed、Embase、科克伦图书馆、循证医学杂志BMJ、资料选择报告SAB患者死亡率和万古霉素MIC的研究纳入本研究。资料提取和综合由两位作者进行文献检索和研究选择分开所有分析均采用随机效应模型。主要结果和措施全因死亡率。结果在38项研究中，涉及8291次SAB，总死亡率为26.1%。高万古霉素MIC（>= 1.5mg/L）患者的SAB发作（n = 2740）的估计死亡率为26.8%，而低万古霉素MIC（= 1.5mg/L）患者的SAB发作（n = 5551）的估计死亡率为25.8%。
IMPORTANCE Staphylococcus aureus bacteremia (SAB) is a worldwide problem. It is unclear whether higher-vancomycin minimum inhibitory concentration (MIC) is associated with mortality. This potential association has direct consequences for patients and public health.DATA SOURCES PubMed, Embase, the Cochrane Library, Evidence-based Medicine BMJ, and the American College of Physicians Journal Club were searched from inception through April 2014.STUDY SELECTION Studies reporting mortality and vancomycin MIC in patients with SAB were included.DATA EXTRACTION AND SYNTHESIS Two authors performed the literature search and the study selection separately. Random-effects modeling was used for all analyses. MAIN OUTCOMES AND MEASURES All-cause mortality.FINDINGS Among 38 included studies that involved 8291 episodes of SAB, overall mortality was 26.1%. The estimated mortality was 26.8% among SAB episodes (n = 2740) in patients with high-vancomycin MIC (>= 1.5mg/L) compared with 25.8% mortality among SAB episodes (n = 5551) in patients with low-vancomycin MIC (= 1.5mg/L) to those with low-vancomycin MIC (