Staphylococcus aureus bacteremia: Compliance with standard treatment, long-term outcome and predictors of relapse
Staphylococcus aureus bacteremia: Compliance with standard treatment, long-term outcome and predictors of relapse
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DOI：
10.1080/00365540310016682
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发表时间：
2003-12-01
影响因子：
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通讯作者：
Khatib, R
中科院分区：
文献类型：
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作者：
Johnson, LB;Almoujahed, MO;Khatib, R
对金黄色葡萄球菌菌血症的标准治疗建议依从性的长期结果进行评估。我们对我院2年期间的金黄色葡萄球菌菌血症病例进行了回顾，并通过回顾随后的入院或与初级保健医生联系进行了随访。我们遇到226例（年龄64.7±15.8岁），大多数（171/ 226,75.7%）没有可切除的源。住院死亡率为32.7%（74/226）。104/152例（68.4%）幸存者（386.7+/-449.8 d）随访显示23.1%（24/104）复发：复发菌血症（n = 19），远处部位（n = 3）和局部复发（n =2）。大多数复发（21/24;87.5%）发生在治疗后90天内。万古霉素治疗的复发率较高（20/48比4/56，p < 0.001），菌血症大于或等于3天（9/20比15/84，p = 0.001），未能清除源（6/7比6/22，p = 0.006）。万古霉素效应与氧西林敏感性无关。19例短时间菌血症患者的治疗时间少于标准2周(
The long-term outcome of compliance with standard treatment recommendations for Staphylococcus aureus bacteremia was assessed. Cases of S. aureus bacteremia at our institution over a 2-y period were reviewed and follow-up performed by review of subsequent admissions or contact with primary care physicians. We encountered 226 cases (age 64.7+/-15.8 y) and most (171/226, 75.7%) had no removable source. In-hospital mortality rate was 32.7% (74/226). Follow-up of 104/152 (68.4%) survivors (for 386.7+/-449.8 d) revealed 23.1% (24/104) relapses: recurrent bacteremia (n = 19), distant site (n = 3) and local recurrence ( n =2). Most relapses (21/24; 87.5%) occurred within 90 d of therapy. Relapse rate was higher with vancomycin treatment (20/48 vs. 4/56; p < 0.001), bacteremia for greater than or equal to 3 d (9/20 vs. 15/84; p = 0.001), and failure to remove the source (6/7 vs. 6/22; p = 0.006). Vancomycin effect was independent of oxacillin susceptibility. Treatment for less than the standard 2-week duration among 19 patients with short duration of bacteremia (