Clinical characteristics and risk factors of polymicrobial Staphylococcus aureus bloodstream infections
Clinical characteristics and risk factors of polymicrobial Staphylococcus aureus bloodstream infections
复制标题
多种微生物金黄色葡萄球菌血流感染的临床特征及危险因素
DOI：
10.1186/s13756-020-00741-6
复制
发表时间：
2020-05-27
影响因子：
5.5
通讯作者：
Zhang, Gensheng
中科院分区：
文献类型：
--
作者：
Zheng, Cheng;Zhang, Shufang;Zhang, Gensheng
背景
虽然金黄色葡萄球菌血流感染（SA-BSI）是一种常见且重要的感染，但多微生物SA-BSI很少报告。本研究的目的是调查的临床特点和危险因素的多微生物SA-BSI相比，单一微生物SA-BSI。
方法
2013年1月1日至2018年12月31日在一家三级医院进行了一项单中心回顾性观察性研究。所有SA-BSI患者均入组，通过审查电子病历收集其临床数据。
结果
共入组349例SA-BSI患者，包括54例（15.5%）多微生物SA-BSI患者。在多变量分析中，烧伤（调整的比值比[OR]，7.04; 95%置信区间[CI]，1.71-28.94），需要输血（aOR，2.72; 95% CI，1.14-6.50），使用机械通气（aOR，3.11; 95%CI，1.16-8.30），既往住院时间（aOR，1.02; 95% CI，1.00-1.03）和以肺炎为主要感染部位（aOR，4.22; 95% CI，1.69-10.51）是多菌SA-BSI的独立影响因素。与单菌SA-BSI相比，多菌SA-BSI患者的ICU住院时间更长[中位数为23（6.25，49.25）vs. 0（0，12），p 0.01]和住院时间[中位天数，50（21.75，85.75）vs. 28（15，49），p 0.01]，并显示出更高的28天死亡率（29.6% vs. 15.3%，p = 0.01）。
结论
烧伤、输血、机械通气、既往住院时间和作为主要感染部位的肺炎是多微生物SA-BSI的独立危险因素。此外，与单菌SA-BSI相比，多菌SA-BSI患者的结局可能更差。
Background
Although Staphylococcus aureus bloodstream infections (SA-BSI) are a common and important infection, polymicrobial SA-BSI are infrequently reported. The aim of this study was to investigate the clinical characteristics and risk factors of polymicrobial SA-BSI in comparison with monomicrobial SA-BSI.
Methods
A single-center retrospective observational study was performed between Jan 1, 2013, and Dec 31, 2018 at a tertiary hospital. All patients with SA-BSI were enrolled, and their clinical data were gathered by reviewing electronic medical records.
Results
A total of 349 patients with SA-BSI were enrolled including 54 cases (15.5%) with polymicrobial SA-BSI. In multivariable analysis, burn injury (adjusted odds ratio [OR], 7.04; 95% confidence interval [CI], 1.71–28.94), need of blood transfusion (aOR, 2.72; 95% CI, 1.14–6.50), use of mechanical ventilation (aOR, 3.11; 95% CI, 1.16–8.30), the length of prior hospital stay (aOR, 1.02; 95% CI, 1.00–1.03), and pneumonia as primary site of infection (aOR, 4.22; 95% CI, 1.69–10.51) were independent factors of polymicrobial SA-BSI. In comparison with monomicrobial SA-BSI, patients with polymicrobial SA-BSI had longer length of ICU stay [median days, 23(6.25,49.25) vs. 0(0,12), p 0.01] and hospital stay [median days, 50(21.75,85.75) vs. 28(15,49), p 0.01], and showed a higher 28-day mortality (29.6% vs. 15.3%, p = 0.01).
Conclusions
Burn injury, blood transfusion, mechanical ventilation, the length of prior hospital stay, and pneumonia as a primary site of infection are independent risk factors for polymicrobial SA-BSI. In addition, patients with polymicrobial SA-BSI might have worse outcomes compared with monomicrobial SA-BSI.