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塞法托林用于由甲基西林耐药黄金葡萄球菌引起的血液感染:一个多中心回顾性队列研究

Sofía de la Villa¹, Francesc Escrihuela-Vidal², Nuria Fernández-Hidalgo³

¹Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

|November 24, 2024

概括

与标准护理相比,Ceftaroline有效治疗了耐甲基黄金葡萄球菌血流感染 (MRSA-BSI),而没有增加死亡率. 然而,与塞夫托林 (ceftaroline) 联合治疗显示不良事件的发生率更高.

科学领域:

传染性疾病传染性疾病
临床药理学临床药理学
抗微生物药物管理委员会

背景情况:

甲素耐药黄金葡萄球菌血流感染 (MRSA-BSI) 是导致发病和死亡的重要原因.
针对MRSA-BSI的治疗选择包括万科米辛和达普托米辛,而塞法托林作为一种潜在的替代品.
对于MRSA-BSI,Ceftaroline和标准护理 (SOC) 剂之间的比较有效性数据有限.

研究的目的:

为了评估Ceftaroline在治疗MRSA-BSI中的有效性,与万科米辛或达普托米辛相比.
评估30天和90天全因死亡率作为主要和次要结局.
为了确定与Ceftaroline治疗相关的不良事件的发生率.

主要方法:

在15家西班牙医院 (2019年1月 - 2022年12月) 进行了MRSA-BSI成年患者的多中心回顾性研究.
患者接受了塞法托林 (第一周内≥72小时) 或SOC (万科米辛/达普托米辛,发病后≥72小时).
倾向性得分匹配和考克斯回归分析被用来控制混因素.

主要成果:

总共分析了429个MRSA-BSI;133个接受了ceftaroline,296个接受了SOC.
在30天死亡率 (23.3%对16.2%,p=0.08) 或90天死亡率 (33.1%对26.7%,p=0.17) 中没有观察到统计学意义上的差异.
副作用的发生率在塞法托林组 (12.0%对4.4%,p<0.01) 较高,特别是在组合治疗中使用时.

结论:

塞法托林在治疗MRSA-BSI方面表现出有效性,死亡率与万科米辛或达普托米辛相比.
塞夫托林经常用于组合疗法,这与不良事件发生率的增加有关.
年龄和高序列器官衰竭评估得分被确定为死亡率的独立预测因素.

关键词:

血流感染血流感染这是一种Ceftaroline.组合疗法是一种联合疗法.在MRSA中,MRSA可能是MRSA.死亡率死亡率死亡率这种病原体是葡萄球菌.

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