Clinical characteristics of and risk factors for secondary bloodstream infection after pneumonia among patients infected with methicillin-resistant Staphylococcus aureus.
Clinical characteristics of and risk factors for secondary bloodstream infection after pneumonia among patients infected with methicillin-resistant Staphylococcus aureus.
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耐甲氧西林金黄色葡萄球菌感染者肺炎后继发血流感染的临床特征及危险因素。
DOI：
10.1016/j.heliyon.2022.e11978
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发表时间：
2022-12
期刊：
影响因子：
4
通讯作者：
Zhang, Gensheng
中科院分区：
文献类型：
--
作者：
Huang, Fangfang;Shen, Ting;Hai, Xin;Xiu, Huiqing;Zhang, Kai;Huang, Tiancha;Chen, Juan;Guan, Zhihui;Zhou, Hongwei;Cai, Jiachang;Cai, Zhijian;Cui, Wei;Zhang, Shufang;Zhang, Gensheng
研究与单纯耐甲氧西林金黄色葡萄球菌（MRSA）肺炎（MP）患者相比，MP合并继发性MRSA血流感染（MRSA BSI）（称为MP-BSI）的临床特征和危险因素，并研究MP患者中MP-BSI的发生率。这是一项回顾性、单中心研究，临床数据来自既往病历。将病例分为两组：MP单独治疗组和MP-BSI组。MP-BSI独立危险因素的确定依赖于logistic回归分析。此外，还比较了粗结果。共招募了435例MP患者，其中18.9%（82/435）患有MP-BSI。中位年龄为62岁（四分位距，51，72），74.5%的患者为男性。多变量分析显示，免疫抑制、社区获得性MP（CA-MP）、从初始到靶向抗生素使用的时间、高序贯器官衰竭评估（SOFA）评分、呼吸频率增加和γ-GT水平升高（均p < 0.05）是MP-BSI的独立风险因素，而利奈唑胺靶向治疗是保护因素。MP-BSI患者的住院时间较长（中位天数，27.5 vs. 19，p = 0.001），28天死亡率较高（24.4% vs. 11.0%，p = 0.001），住院死亡率较高（26.8% vs. 14.7%，p = 0.009）。MP患者中继发性MRSA-BSI并不罕见。免疫抑制、CA-MP、从初始到靶向抗生素使用的时间、高SOFA评分、呼吸频率增加和γ-GT水平升高均为MP-BSI的独立风险因素;然而，利奈唑胺作为靶向抗生素是保护因素。此外，MP患者在发生MRSA-BSI时可能会有更差的临床结局。继发性MRSA血流感染在MRSA肺炎中并不少见。一些因素（例如，高SOFA评分）是血流感染的预测因子。利奈唑胺作为靶向抗生素是一种保护因素。继发性血流感染会加重肺炎的临床结局。耐甲氧西林金黄色葡萄球菌，肺炎，血流感染，危险因素。
To investigate the clinical features and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia (MP) with secondary MRSA bloodstream infections (MRSA-BSI) (termed MP-BSI) compared with MP alone and to study the incidence of MP-BSI among patients with MP. This was a retrospective, single-center study with clinical data derived from previous medical records. The cases were divided into groups: MP alone and MP-BSI. The determination of independent risk factors for MP-BSI relied on logistic regression analysis. Additionally, the crude outcomes were compared. A total of 435 patients with MP were recruited, with 18.9% (82/435) having MP-BSI. The median age was 62 (interquartile range, 51,72) years, and 74.5% of the patients were male. Multivariate analysis revealed that immunosuppression, community-acquired MP (CA-MP), time from initial to targeted antibiotic use, high Sequential Organ Failure Assessment (SOFA) score, increased respiratory rate, and elevated γ-GT level (all p < 0.05) were independent risk factors for MP-BSI, while targeted treatment with linezolid was a protective factor. Patients with MP-BSI had a longer duration of hospitalization (median days, 27.5 vs. 19, p = 0.001), a higher 28-day mortality rate (24.4% vs. 11.0%, p = 0.001), and a higher in-hospital mortality rate (26.8% vs. 14.7%, p = 0.009) than those with MP alone. Secondary MRSA-BSI among patients with MP is not rare. Immunosuppression, CA-MP, time from initial to targeted antibiotic use, high SOFA score, increased respiratory rate and elevated γ-GT level are all independent risk factors for MP-BSI; however, linezolid, as a targeted antibiotic, is a protective factor. Moreover, patients with MP may have worse clinical outcomes when they develop MRSA-BSI. Secondary MRSA bloodstream infection is not uncommon in MRSA pneumonia. Some factors (e.g., high SOFA score) are predictors of bloodstream infection. Linezolid as a targeted antibiotic is a protective factor. Secondary bloodstream infection will worsen clinical outcomes of pneumonia. Methicillin-resistant Staphylococcus aureus, Pneumonia, Bloodstream infections, Risk factors.
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DOI：
10.1016/j.ijantimicag.2008.06.006
发表时间：
2008-11-01
影响因子：
10.8
作者：
Rubinstein, Ethan
通讯作者：
Rubinstein, Ethan
影响因子：
11.8
作者：
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通讯作者：
Brozek, Jan L.
影响因子：
2.6
作者：
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通讯作者：
Kekilli, Murat
影响因子：
1.5
作者：
Boots, RJ;Lipman, J;Heller, RE
通讯作者：
Heller, RE
DOI：
10.1186/s13049-018-0525-y
发表时间：
2018-07-13
影响因子：
3.3
作者：
Quinten, Vincent M.;van Meurs, Matijs;ter Maaten, Jan C.
通讯作者：
ter Maaten, Jan C.