Staphylococcus aureus bloodstream infection: a pooled analysis of five prospective, observational studies.
Staphylococcus aureus bloodstream infection: a pooled analysis of five prospective, observational studies.
复制标题
DOI：
10.1016/j.jinf.2013.10.015
复制
发表时间：
2014-03
影响因子：
28.2
通讯作者：
Thwaites, Guy E.
中科院分区：
文献类型：
--
作者：
Kaasch, Achim J.;Barlow, Gavin;Edgeworth, Jonathan D.;Fowler, Vance G.;Hellmich, Martin;Hopkins, Susan;Kern, Winfried V.;Llewelyn, Martin J.;Rieg, Siegbert;Rodriguez-Bano, Jesus;Scarborough, Matthew;Seifert, Harald;Soriano, Alex;Tilley, Robert;Torok, M. Estee;Weiss, Verena;Wilson, A. Peter R.;Thwaites, Guy E.
金黄色葡萄球菌菌血症是一种常见的，往往是致命的感染。我们的目的是描述其临床表现如何在人群之间变化，并确定结果的共同决定因素。我们对3395例连续的成人S。金黄色菌血症患者于2006年至2011年在德国、西班牙、英国和美国的20家三级医疗中心参加了5项前瞻性研究。参与者的中位年龄为64岁（四分位数范围50-75岁），63.8%为男性。25.4%的感染与糖尿病有关，40.7%为医院感染，20.6%为耐甲氧西林链球菌感染。金黄色葡萄球菌（MRSA），尽管这些比例在研究中有显著差异。静脉导管是最常见的感染病灶（27.7%）; 8.3%患有心内膜炎。14天和90天的粗死亡率分别为14.6%和29.2%。年龄、MRSA菌血症、院内感染、心内膜炎和肺炎与死亡独立相关，但与不明感染灶的关系较强（90天死亡率的校正风险比为2.92; 95%置信区间为2.33 ~ 3.67，p < 0.0001）。基线人口统计学和临床特征的S。金黄色葡萄球菌菌血症在人群之间差异显著。通过严格控制MRSA和早期识别感染病灶可以降低死亡率。
Staphylococcus aureus bacteraemia is a common, often fatal infection. Our aim was to describe how its clinical presentation varies between populations and to identify common determinants of outcome. We conducted a pooled analysis on 3395 consecutive adult patients with S. aureus bacteraemia. Patients were enrolled between 2006 and 2011 in five prospective studies in 20 tertiary care centres in Germany, Spain, United Kingdom, and United States. The median age of participants was 64 years (interquartile range 50–75 years) and 63.8% were male. 25.4% of infections were associated with diabetes mellitus, 40.7% were nosocomial, 20.6% were caused by methicillin-resistant S. aureus (MRSA), although these proportions varied significantly across studies. Intravenous catheters were the commonest identified infective focus (27.7%); 8.3% had endocarditis. Crude 14 and 90-day mortality was 14.6% and 29.2%, respectively. Age, MRSA bacteraemia, nosocomial acquisition, endocarditis, and pneumonia were independently associated with death, but a strong association was with an unidentified infective focus (adjusted hazard ratio for 90-day mortality 2.92; 95% confidence interval 2.33 to 3.67, p < 0.0001). The baseline demographic and clinical features of S. aureus bacteraemia vary significantly between populations. Mortality could be reduced by assiduous MRSA control and early identification of the infective focus.
登录
查看更多内容
影响因子：
3.7
作者：
Gill SR;McIntyre LM;Nelson CL;Remortel B;Rude T;Reller LB;Fowler VG Jr
通讯作者：
Fowler VG Jr
影响因子：
3.7
作者：
Thwaites GE;United Kingdom Clinical Infection Research Group (UKCIRG)
通讯作者：
United Kingdom Clinical Infection Research Group (UKCIRG)
影响因子：
11.8
作者：
Li, JS;Sexton, DJ;Corey, GR
通讯作者：
Corey, GR
影响因子：
2.1
作者：
Hill, PC;Birch, M;Morris, AJ
通讯作者：
Morris, AJ
DOI：
10.1186/1755-7682-4-33
发表时间：
2011-10-04
期刊：
International archives of medicine
影响因子：
--
作者：
Rebelo M;Pereira B;Lima J;Decq-Mota J;Vieira JD;Costa JN
通讯作者：
Costa JN