Recurrent Staphylococcus aureus bacteremia:: Pulsed-field gel electrophoresis findings in 29 patients
Recurrent Staphylococcus aureus bacteremia:: Pulsed-field gel electrophoresis findings in 29 patients
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DOI：
10.1086/314712
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发表时间：
1999-05-01
影响因子：
6.4
通讯作者：
Harrell, LJ
中科院分区：
文献类型：
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作者：
Fowler, VG;Kong, LK;Harrell, LJ
为确定309例前瞻性确定的金黄色葡萄球菌菌血症复发的危险因素，复发性金黄色葡萄球菌患者。鉴定金黄色葡萄球菌菌血症，并对来自两次发作的分离株进行脉冲场凝胶电泳（PFGE）。两种分离株的PFGE带型在23例患者中相同，与复发感染一致。经单因素和多因素分析，经PFGE证实复发的患者更有可能存在留置异物（比值比[OR] = 18.2，95%置信区间[CI] = 7.6-43.6; P < .001），接受万古霉素治疗（OR = 4.1，95%CI = 1.5-11.6; P = 0.008）或依赖于血液透析（OR = 4.1，95%CI = 1.8-9.3; P = 0.002）。这些结果表明，反复发作的S。金黄色葡萄球菌菌血症主要是复发性的，并且与留置异物、接受万古霉素治疗和血液透析依赖性有关。
To identify risk factors for relapse among 309 prospectively identified cases of Staphylococcus aureus bacteremia, patients with recurrent S. aureus bacteremia were identified, and pulsed-field gel electrophoresis (PFGE) was performed on isolates from both episodes. PFGE banding patterns from both isolates were identical in 23 patients, consistent with relapsed infection. Patients with PFGE-confirmed relapse were more likely by both univariate and multivariate analyses to have an indwelling foreign body (odds ratio [OR] = 18.2, 95% confidence interval [CI] = 7.6-43.6; P < .001), to have received vancomycin therapy (OR = 4.1, 95% CI = 1.5-11.6; P = .008), or be hemodialysis-dependent (OR = 4.1, 95% CI = 1.8-9.3; P = .002) than patients who did not develop recurrent bacteremia. These results suggest that recurrent episodes of S. aureus bacteremia are primarily relapses and are associated with an indwelling foreign body, receiving vancomycin therapy, and hemodialysis dependence.