Clinical characteristics and prognosis analysis of patient with Methicillin-susceptible Staphylococcus aureus, or Methicillin-resistant Staphylococcus aureus Bacteremia / 中华急诊医学杂志

ABSTRACT

Objective To investigate the clinical characteristics and prognosis analysis of patient with bacteremia induced by Methicillin-susceptible Staphylococcus aureus (MSSA) or Methicillin-resistant Staphylococcus aureus (MRSA).Methods This retrospective study included 95 Staphylococcus aureus Bacteremia (SAB) patients admitted to Nanjing Drum Tower hospital from January 2012 to December 2017.According to the drug sensitivity tests,patients were divided into MSSA group and MRSA group.Clinical characteristics,systematic score and prognosis were compared between these two group.APACHE Ⅱ score and SOFA score were analyzed by independent-samples t test.The distribution of primary disease and basic disease,bacterium source,and prognostic factors were analyzed by Mann—Whitney U test or x2 test.The cumulative survival was calculated by the Kaplan-Meier method.Wilcoxon rank sum test was selected for survival rate comparison.Results There are 56 MSSA strain and 39 MRSA strain among the 95 SAB patients,the detection rate is 58.95％ and 41.05％,respectively.The most common primary disease of SAB is catheter-related infections(23 cases,24.21％).Compared with MSSA group,the catheter-related infections has higher detection rate of MRSA obviously (P＜0.01).The most common underlying disease of SAB is diabetes (35 cases,36.84％).Compared with MSSA,MRSA is more frequent appear in SAB patients combine with renal dysfunction (28 cases,29.47％).The third disease is cardiac insufficiency (22 cases,23.16％).The community-acquired SAB is fifty-two and the majority of strains is MSSA.The hospital-acquired SAB is forty-three and mainly of them is MRSA.The Sepsis related Organ Failure Assessment (SOFA) score of MRSA group are higher than MSSA significantly (t=2.203,P=0.024).However,there is no significant differences between MSSA and MRSA group in APACHE Ⅱ score,cases of hospitalized beyond 30 days and 28-days survival rate (P ＞ 0.05).Conclusions The majority of strains in the SAB patients is MSSA.In clinical characteristics,compared with MSSA,MRSA is more common in nosocomial infection,catheter related infection and renal dysfunction patients.There is no significant differences in prognosis between MSSA group and MRSA group.