Community-associated methicillin-resistant Staphylococcus aureus bacteremia and endocarditis among HIV patients: a cohort study.
Community-associated methicillin-resistant Staphylococcus aureus bacteremia and endocarditis among HIV patients: a cohort study.
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DOI：
10.1186/1471-2334-11-298
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发表时间：
2011-10-31
影响因子：
3.7
通讯作者：
Forrest GN
中科院分区：
文献类型：
--
作者：
Furuno JP;Johnson JK;Schweizer ML;Uche A;Stine OC;Shurland SM;Forrest GN
艾滋病毒患者感染和与感染相关的不良健康结果的风险增加。我们的目的是：1）评估USA 300社区相关耐甲氧西林金黄色葡萄球菌（CA-MRSA）在HIV感染患者中的患病率。金黄色葡萄球菌血流感染和。2)确定感染性心内膜炎的危险因素和该人群患者的住院死亡率。所有患有S.包括2003年1月1日至2005年12月31日期间在马里兰州医学中心大学住院的金黄色葡萄球菌菌血症患者。CA-MRSA定义为具有MBQBLO spa型基序的USA 300 MRSA分离株，精氨酸分解代谢移动的元件和Panton-Valentin杀白细胞素均呈阳性。S的危险因素使用逻辑回归计算优势比（OR）和95%置信区间（CI），确定金黄色葡萄球菌相关感染性心内膜炎和死亡率。潜在的危险因素包括人口统计学变量、共病和静脉注射毒品。在131次S.金黄色葡萄球菌菌血症85例（66%），其中CA-MRSA 47例（54%）。63例患者（48%）发生心内膜炎，10例患者（8%）在入院时死亡。CA-MRSA患者发生心内膜炎的可能性显著增加（OR = 2.73，95%CI = 1.30，5.71）。没有其他变量，包括合并症，目前接受抗逆转录病毒治疗，前培养疾病的严重程度，或CD 4计数与心内膜炎显着相关，没有相关的住院死亡率。CA-MRSA与这组MRSA菌血症HIV患者心内膜炎发病率的增加显著相关。在这些人群中，静脉注射毒品的流行率和心内膜炎的可能性都很高，必须努力早期发现，这可能会改善治疗结果。
HIV patients are at increased risk of development of infections and infection-associated poor health outcomes. We aimed to 1) assess the prevalence of USA300 community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) among HIV-infected patients with S. aureus bloodstream infections and. 2) determine risk factors for infective endocarditis and in-hospital mortality among patients in this population. All adult HIV-infected patients with documented S. aureus bacteremia admitted to the University of Maryland Medical Center between January 1, 2003 and December 31, 2005 were included. CA-MRSA was defined as a USA300 MRSA isolate with the MBQBLO spa-type motif and positive for both the arginine catabolic mobile element and Panton-Valentin Leukocidin. Risk factors for S. aureus-associated infective endocarditis and mortality were determined using logistic regression to calculate odds ratios (OR) and 95% confidence intervals (CI). Potential risk factors included demographic variables, comorbid illnesses, and intravenous drug use. Among 131 episodes of S. aureus bacteremia, 85 (66%) were MRSA of which 47 (54%) were CA-MRSA. Sixty-three patients (48%) developed endocarditis and 10 patients (8%) died in the hospital on the index admission Patients with CA-MRSA were significantly more likely to develop endocarditis (OR = 2.73, 95% CI = 1.30, 5.71). No other variables including comorbid conditions, current receipt of antiretroviral therapy, pre-culture severity of illness, or CD4 count were significantly associated with endocarditis and none were associated with in-hospital mortality. CA-MRSA was significantly associated with an increased incidence of endocarditis in this cohort of HIV patients with MRSA bacteremia. In populations such as these, in which the prevalence of intravenous drug use and probability of endocarditis are both high, efforts must be made for early detection, which may improve treatment outcomes.
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影响因子：
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作者：
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通讯作者：
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120.7
作者：
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DOI：
10.1016/j.diagmicrobio.2011.03.010
发表时间：
2011-07
影响因子：
2.9
作者：
Kreisel, Kristen M.;Stine, O. Colin;Johnson, J. Kristie;Perencevich, Eli N.;Shardell, Michelle D.;Lesse, Alan J.;Gordin, Fred M.;Climo, Michael W.;Roghmann, Mary-Claire
通讯作者：
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