医学
万古霉素
菌血症
优势比
耐甲氧西林金黄色葡萄球菌
内科学
金黄色葡萄球菌
置信区间
抗生素
葡萄球菌感染
微生物学
遗传学
生物
细菌
作者
Ethan Canty,Benjamin Carnahan,Tara Curley,Emily Anususinha,Rana F. Hamdy,Jessica E. Ericson
出处
期刊:Pediatric Infectious Disease Journal
[Ovid Technologies (Wolters Kluwer)]
日期:2020-11-13
卷期号:40 (5): 429-433
被引量:7
标识
DOI:10.1097/inf.0000000000002992
摘要
Clinical implications of reduced vancomycin susceptibility (RVS) among pediatric Staphylococcus aureus bloodstream infections are unknown.We identified all children at 2 children's hospitals with ≥1 blood culture positive for S. aureus. We compared patient and clinical factors for RVS and non-RVS infections using Wilcoxon rank-sum and chi-squared tests. Treatment failure and the duration of bacteremia for RVS versus non-RVS and for methicillin-resistant Staphylococcus aureus (MRSA) versus methicillin-susceptible Staphylococcus aureus (MSSA) infections were compared using multivariable logistic and Poisson regressions, respectively. For MRSA infections, the association of empiric vancomycin monotherapy with treatment failure was assessed using multivariable logistic regression.RVS was present in 72% (309/426) of cases. No patient or infection characteristics, including methicillin resistance, were associated with RVS. RVS was associated with an increased duration of bacteremia compared with non-RVS infections, aIRR = 1.15 (95% confidence interval: 1.02-1.30). The odds of treatment failure was similar for RVS and non-RVS infections, aOR = 1.04 (0.62-1.74). In contrast, MRSA infections were more likely to have treatment failure than MSSA infections, aOR = 3.03 (95% confidence interval: 1.84-5.00). For MRSA infections, empiric vancomycin monotherapy was associated with an increased odds of treatment failure compared with non-vancomycin or combination anti-MRSA antibiotics, aOR = 3.23 (1.12-9.26).RVS was common and was associated with a longer duration of bacteremia but not with treatment failure. Treatment failure was more common for MRSA than for MSSA bloodstream infections. Empiric vancomycin monotherapy increased the odds of treatment failure for MRSA infections.
科研通智能强力驱动
Strongly Powered by AbleSci AI