Clinical significance of Staphylococcus aureus bacteriuria at a tertiary care hospital
Clinical significance of Staphylococcus aureus bacteriuria at a tertiary care hospital
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DOI：
10.3109/00365548.2013.803291
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发表时间：
2013-09-01
影响因子：
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通讯作者：
Darouiche, Rabih O.
中科院分区：
文献类型：
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作者：
Al Mohajer, Mayar;Musher, Daniel M.;Darouiche, Rabih O.
目的：金黄色葡萄球菌菌尿与侵袭性葡萄球菌有关。金黄色葡萄球菌病本项目阐述了S.金黄色菌尿方法：我们对S。金黄色葡萄球菌菌尿在迈克尔E. DeBakey退伍军人事务医疗中心，2008-2010年。结果：共纳入326例患者。入侵S。56例患者在菌尿12个月内记录了金黄色葡萄球菌病（22.3%的耐甲氧西林金黄色葡萄球菌）。金黄色葡萄球菌（MRSA）和8.4%的甲氧西林敏感的S。金黄色葡萄球菌（MSSA），p = 0.002）。多元逻辑回归分析表明，MRSA菌尿（优势比（OR）2.91，p = 0.010），无提示尿路感染（UTI）的症状（OR 3.21，p = 0.019），住院状态（OR 4.72，p = 0.003）和接受抗S.金黄色葡萄球菌（OR 6.41，p < 0.001）与侵袭性葡萄球菌的存在显著相关。金黄色葡萄球菌病77例患者（23.6%）在记录的S.金黄色菌尿年龄（OR 1.02，p = 0.025）、无脓尿（OR 2.00，p = 0.029）、是否存在侵袭性S.金黄色葡萄球菌病（OR 2.05，p = 0.033）和住院状态（OR 3.62，p < 0.001）与死亡显著相关。结论：S.金黄色菌尿与显著的发病率和死亡率相关。没有UTI症状的患者，MRSA菌尿患者，以及没有脓尿的患者更有可能有更差的预后（侵袭性S。金黄色葡萄球菌病或死亡）。在这些情况下应考虑获取血培养。
Objectives: Staphylococcus aureus bacteriuria has been associated with invasive S. aureus disease. The current project describes the clinical significance of S. aureus bacteriuria. Methods: We conducted a retrospective chart review of patients who had S. aureus bacteriuria at the Michael E. DeBakey Veterans Affairs Medical Center, 2008-2010. Results: A total of 326 patients were included. Invasive S. aureus disease was documented within 12 months of bacteriuria in 56 patients (22.3% of methicillin-resistant S. aureus (MRSA) cases and 8.4% of methicillin-sensitive S. aureus (MSSA), p = 0.002). Multiple logistic regression indicated that MRSA bacteriuria (odds ratio (OR) 2.91, p = 0.010), absence of symptoms suggestive of a urinary tract infection (UTI) (OR 3.21, p = 0.019), inpatient status (OR 4.72, p = 0.003), and receipt of antibiotics active against S. aureus (OR 6.41, p < 0.001) were significantly associated with the presence of invasive S. aureus disease. Seventy-seven patients (23.6%) died within 12 months of the documented S. aureus bacteriuria. Age (OR 1.02, p = 0.025), absence of pyuria (OR 2.00, p = 0.029), the presence of invasive S. aureus disease (OR 2.05, p = 0.033), and inpatient status (OR 3.62, p < 0.001) were significantly associated with death. Conclusions: S. aureus bacteriuria is associated with significant morbidity and mortality. Patients without UTI symptoms, those with MRSA bacteriuria, and those without pyuria were more to likely to have worse outcomes (invasive S. aureus disease or death). Obtaining blood cultures should be considered in these cases.