Staphylococcus aureus endocarditis -: A consequence of medical progress

被引:812
作者
Fowler, VG
Miro, JM
Hoen, B
Cabell, CH
Abrutyn, E
Rubinstein, E
Corey, GR
Spelman, D
Bradley, SF
Barsic, B
Pappas, PA
Anstrom, KJ
Wray, D
Fortes, CQ
Anguera, I
Athan, E
Jones, P
van der Meer, JTM
Elliott, TSJ
Levine, DP
Bayer, AS
机构
[1] Duke Univ, Med Ctr, Div Infect Dis, Durham, NC 27710 USA
[2] Univ Barcelona, Hosp Clin, IDIBAPS, E-08007 Barcelona, Spain
[3] Hop St Jacques, F-25030 Besancon, France
[4] Drexel Univ, Coll Med, Philadelphia, PA 19104 USA
[5] Tel Aviv Univ, Sch Med, IL-69978 Tel Aviv, Israel
[6] Alfred Hosp, Melbourne, Vic, Australia
[7] Univ Michigan, Ann Arbor, MI 48109 USA
[8] Univ Zagreb, Univ Hosp Infect Dis, Zagreb, Croatia
[9] Med Univ S Carolina, Charleston, SC 29425 USA
[10] Hosp Univ Clementino Fraga Filho, Rio De Janeiro, Brazil
[11] Hosp Sabadell, Sabadell, Spain
[12] Geelong Hosp, Geelong, Vic, Australia
[13] Prince Wales Hosp, Sydney, NSW, Australia
[14] Univ Amsterdam, Acad Med Ctr, NL-1012 WX Amsterdam, Netherlands
[15] Queen Elizabeth Hosp, Birmingham B15 2TH, W Midlands, England
[16] Wayne State Univ, Detroit, MI USA
[17] Harbor UCLA Med Ctr, Los Angeles, CA USA
[18] LA Biomed Res Inst, Los Angeles, CA USA
来源
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 2005年 / 293卷 / 24期
关键词
D O I
10.1001/jama.293.24.3012
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Context The global significance of infective endocarditis (IE) caused by Staphylococcus aureus is unknown. Objectives To document the international emergence of health care-associated S aureus IE and methicillin-resistant S aureus (MRSA) IE and to evaluate regional variation in patients with S aureus IE. Design, Setting, and Participants Prospective observational cohort study set in 39 medical centers in 16 countries. Participants were a population of 1779 patients with definite IE as defined by Duke criteria who were enrolled in the International Collaboration on Endocarditis-Prospective Cohort Study from June 2000 to December 2003. Main Outcome Measure In-hospital mortality. Results S aureus was the most common pathogen among the 1779 cases of definite IE in the International Collaboration on Endocarditis Prospective-Cohort Study (558 patients, 31.4%). Health care-associated infection was the most common form of S aureus IE (218 patients, 39.1%), accounting for 25.9% (Australia/New Zealand) to 54.2% (Brazil) of cases. Most patients with health care-associated S aureus I E (131 patients, 60.1%) acquired the infection outside of the hospital. MRSA IE was more common in the United States (37.2%) and Brazil (37.5%) than in Europe/Middle East (23.7%) and Australia/ New Zealand (15.5%, P<.001). Persistent bacteremia was independently associated with MRSA IE (odds ratio, 6.2; 95% confidence interval, 2.9-13.2). Patients in the United States were most likely to be hemodialysis dependent, to have diabetes, to have a presumed intravascular device source, to receive vancomycin, to be infected with MRSA, and to have persistent bacteremia (P<.001 for all comparisons). Conclusions S aureus is the leading cause of IE in many regions of the world. Characteristics of patients with S aureus IE vary significantly by region. Further studies are required to determine the causes of regional variation.
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收藏
页码:3012 / 3021
页数:10
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