PDF(Pubmed)
Abstract：
Staphylococcus aureus bacteraemia (SAB) is a bloodstream infection that carries a high risk of exacerbating a diseased state and may result in an increased death rate. The aim of this study was to assess mortality risk in Methicillin Resistant Staphylococcus aureus (MRSA) bacteraemia compared to Methicillin Susceptible Staphylococcus aureus (MSSA) bacteraemia through meta-meta-analyses. The study followed PRISMA guidelines, conducting a comprehensive search in Scopus, PubMed, and Google Scholar. It included full-text systematic reviews and meta-analyses comparing MRSA vs. MSSA bacteraemia, excluding reviews without data pooling and unclear selection criteria. Validity was assessed using QUOROM and AMSTAR. Edwards\' Venn diagrams were used to visualized overlaps between primary studies. Aggregated odds ratio (OR) and risk ratios with 95% confidence intervals were calculated using the random-effect model. Heterogeneity was evaluated using the Higgins I2 statistic. The study included 3 meta-analysis studies, a total of 38,159 patients, with 9,056 having MRSA bacteraemia and 29,103 having MSSA bacteraemia. Data were collected from 46 different outcome studies published between 2001 and 2022. The meta-analyses used 7 to 33 primary studies from 1990 to 2020, with no overlap. Odds ratios (ORs) ranged from 1.78 to 2.92, while relative risks (RR) ranged from 1.57 to 2.37 for the included meta-anlysis. The pooled analysis confirmed a higher risk of mortality in patients with MRSA bacteraemia (OR: 2.35, RR: 2.01, HR: 1.61) compared to MSSA bacteraemia. Heterogeneity among the studies was considerable (I2: 90-91%). The study strongly supports that most patient deaths from SAB are linked to MRSA rather than MSSA. This highlights the significant public health problem posed by SAB, with difficult and often unsuccessful treatment leading to increased mortality and high healthcare costs.
摘要：
金黄色葡萄球菌菌血症（SAB）是一种血液感染，具有加剧疾病状态的高风险，并可能导致死亡率增加。这项研究的目的是通过荟萃分析评估耐甲氧西林金黄色葡萄球菌（MRSA）菌血症与耐甲氧西林金黄色葡萄球菌（MSSA）菌血症的死亡风险。这项研究遵循了PRISMA指南，在Scopus进行全面搜索，PubMed,谷歌学者。它包括比较MRSA与MRSA的全文系统评价和荟萃分析MSSA菌血症，不包括没有数据汇集和选择标准不明确的评论.使用QUOROM和AMSTAR评估有效性。爱德华兹维恩图用于可视化主要研究之间的重叠。使用随机效应模型计算具有95%置信区间的总比值比(OR)和风险比。使用HigginsI2统计量评估异质性。该研究包括3项荟萃分析研究，共有38159名病人,其中9,056人患有MRSA菌血症，29,103人患有MSSA菌血症。数据来自2001年至2022年发表的46项不同结果研究。荟萃分析使用了1990年至2020年的7至33项主要研究，没有重叠。纳入的荟萃分析的赔率比（ORs）为1.78至2.92，而相对风险（RR）为1.57至2.37。汇总分析证实，与MSSA菌血症相比，MRSA菌血症患者的死亡风险更高（OR：2.35，RR：2.01，HR：1.61）。研究之间的异质性是相当大的(I2:90-91%)。该研究强烈支持大多数SAB患者死亡与MRSA而不是MSSA有关。这凸显了SAB带来的重大公共卫生问题，治疗困难且往往不成功，导致死亡率增加和医疗费用高。
