■本文旨在确定COVID-19大流行期间金黄色葡萄球菌菌血症(SAB)住院死亡率及其相关危险因素。
■在2020年3月至2022年3月期间,在德黑兰的一家教学医院共收集了167个SAB样本,伊朗。收集患者的基线数据和抗菌谱。研究的结果是院内死亡率。
■总体住院死亡率为41.9%,在60岁以上的患者中观察到更高的死亡率(P=0.032),社区获得性金黄色葡萄球菌菌血症患者(P=0.010),ICU患者(P=0.016)。抗生素耐药谱表明,耐药金黄色葡萄球菌菌株的死亡率较高,但环丙沙星的死亡率仅显著(P=0.001),甲氧西林(P=0.047),和磺胺甲恶唑(P=0.023)。多变量分析确定的年龄,性别,入住ICU,菌血症的来源是死亡率的独立预测因子,而COVID-19合并感染和对抗生素的耐药性没有发现是显著的预测因素。
■SAB仍然是一种具有挑战性的感染,并被大流行所放大。高龄和入住ICU是重要的死亡率预测因素。在MRSA患病率较高的地区,像年龄这样的因素,性别,和护理质量超过病原体相关因素,如抗生素耐药性。
UNASSIGNED: This paper aims to determine the Staphylococcus aureus bacteremia (SAB) in-hospital mortality rate and its associated risk factors during the COVID-19 pandemic.
UNASSIGNED: A total of 167 SAB samples were collected between March 2020 and March 2022 at a teaching hospital in Tehran, Iran. The patient\'s baseline data and antibiograms were collected. The outcome of the study was in-hospital mortality.
UNASSIGNED: The overall in-hospital mortality rate was 41.9 %, with higher mortality observed in patients over 60 years old (P = 0.032), those with community-acquired Staphylococcus aureus bacteremia (P = 0.010), and those admitted to the ICU (P = 0.016). Antibiotic resistance profiles indicated a higher mortality in resistant S.aureus strains but only significant for ciprofloxacin (P = 0.001), methicillin (P = 0.047), and sulfamethoxazole (P = 0.023). Multivariate analysis identified age, sex, ICU admission, and the source of bacteremia as independent predictors of mortality, while COVID-19 coinfection and resistance to antibiotics were not found to be significant predictors.
UNASSIGNED: SAB remains a challenging infection that is amplified by the pandemic. Older age and ICU admission are significant mortality predictors. In settings with a high prevalence of MRSA, factors like age, sex, and quality of care outweigh pathogen-related factors such as antibiotic resistance.