Outcomes analysis of delayed antibiotic treatment for hospital-acquired Staphylococcus aureus bacteremia.
Outcomes analysis of delayed antibiotic treatment for hospital-acquired Staphylococcus aureus bacteremia.
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DOI：
10.1086/375057
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发表时间：
2003-06-01
影响因子：
11.8
通讯作者：
Rybak, Michael J.
中科院分区：
文献类型：
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作者：
Lodise, Thomas P.;McKinnon, Peggy S.;Rybak, Michael J.
本研究的目的是确定延迟治疗对院内金黄色葡萄球菌菌血症相关发病率和死亡率的影响。该研究包括所有S。1999年至2001年期间入院后>2天发生的金黄色葡萄球菌菌血症。分类和回归树分析（CART）用于选择早期和延迟治疗之间的死亡率折点。在25个月的研究期间，167例患者符合入选标准。使用CART得出的延迟和早期治疗之间的断点为44.75小时。多变量分析发现，延迟治疗是感染相关死亡率的独立预测因子（比值比，3.8; 95%置信区间，1.3-11.0; P = 0.01），与早期治疗相比，延迟治疗与更长的住院时间相关（20.2天vs 14.3天; P = 0.05）。这些发现支持了延迟治疗对临床结果有有害影响的观点，应努力确保及时启动适当的治疗。
The objective of this study was to determine the effect of delayed therapy on morbidity and mortality associated with nosocomial Staphylococcus aureus bacteremia. The study included all episodes of S. aureus bacteremia that developed >2 days after hospital admission during 1999 to 2001. Classification and regression tree analysis (CART) was used to select the mortality breakpoint between early and delayed treatment. During the 25-month study period, 167 patients met the inclusion criteria. The breakpoint between delayed and early treatment derived using CART was 44.75 hours. On multivariate analysis, delayed treatment was found to be an independent predictor of infection-related mortality (odds ratio, 3.8; 95% confidence interval, 1.3-11.0; P = .01) and was associated with a longer hospital stay than was early treatment (20.2 days versus 14.3 days; P = .05). These findings support the notion that delay of therapy has deleterious effects on clinical outcomes, and efforts should be made to ensure that appropriate therapy is initiated promptly.