USA300 methicillin-resistant Staphylococcus aureus bacteremia and the risk of severe sepsis: is USA300 methicillin-resistant Staphylococcus aureus associated with more severe infections?
USA300 methicillin-resistant Staphylococcus aureus bacteremia and the risk of severe sepsis: is USA300 methicillin-resistant Staphylococcus aureus associated with more severe infections?
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DOI：
10.1016/j.diagmicrobio.2011.03.010
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发表时间：
2011-07
影响因子：
2.9
通讯作者：
Roghmann, Mary-Claire
中科院分区：
文献类型：
--
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
关键词：
USA 300耐甲氧西林金黄色葡萄球菌（MRSA）作为严重社区相关菌血症感染的原因正在增加。我们评估了USA 300 MRSA与非USA 300 MRSA菌血症患者感染后的严重脓毒症。1997-2008年进行了一项队列研究，比较了来自四家VA医院的271例MRSA菌血症患者感染后的脓毒症。67例（25%）MRSA菌血症患者为USA 300 MRSA; 204例（75%）为非USA 300 MRSA。由USA 300 MRSA引起的MRSA菌血症的比例随时间增加（χ2 p<0.0001）。调整年龄和医院感染后，USA 300 MRSA菌血症患者比非USA 300 MRSA菌血症患者更可能发生严重脓毒症或感染性休克（调整后的相对风险=1.82; 95%CI：1.16-2.87; p=0.01）。这表明USA 300 MRSA患者更有可能在感染后发生严重脓毒症，这可能是由于宿主或细菌差异所致。
USA300 methicillin-resistant Staphylococcus aureus (MRSA) is increasing as a cause of severe community-associated bacteremic infections. We assessed severe sepsis in response to infection in patients with USA300 MRSA compared to non-USA300 MRSA bacteremia. A cohort study was conducted from 1997–2008 comparing sepsis in response to infection in 271 patients with MRSA bacteremia from four VA hospitals. Sixty-seven (25%) patients with MRSA bacteremia were USA300 MRSA; 204 (75%) were non-USA300 MRSA. The proportion of MRSA bacteremia caused by USA300 MRSA increased over time (χ2 p<0.0001). Adjusting for age and nosocomial infection, patients with USA300 MRSA bacteremia were more likely to have severe sepsis or septic shock in response to infection than patients with non-USA300 MRSA bacteremia (adjusted Relative Risk=1.82; 95% CI: 1.16–2.87; p=0.01). This suggests that patients with USA300 MRSA are more likely to develop severe sepsis in response to their infection, which could be due to host or bacterial differences.
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