NHẬN XÉT KẾT QUẢ ĐIỀU TRỊ BỆNH NHÂN NHIỄM KHUẨN HUYẾT DO STAPHYLOCOCCUS AUREUS KHÁNG METHICILLIN (MRSA) TẠI BỆNH VIỆN ĐẠI HỌC Y HÀ NỘI

Abstract

A retrospective study was conducted to evaluate the treatment outcomes of 112 inpatients with methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections treated at Hanoi Medical University Hospital from 2021 to 2025. Results: In MRSA bloodstream infection patients, the most common sources of infection were skin-soft tissue infections and muscle abscess (60.7% and 20.5%, respectively). The mortality rate was 18.8%. There were 98 of 112 patients (87.5%) receiving appropriate initial antibiotics with vancomycin or linezolid. The rate of antibiotic switching in the vancomycin group was 53.7% (36/67 patients), mainly due to non-response to vancomycin (37.3%) and vancomycin allergy (11.9%). The univariate analysis showed that, factors associated with the risk of mortality included age more than 65 years (OR=3.06; 95% CI 1.12–8.31; p=0.029), diabetes mellitus (OR 4.74; 95% CI 1.72–13.05; p=0.003), failure of two or more organs (OR=3.74; 95% CI 1.06–13.3; p=0.041), septic shock (OR=18.92; 95% CI 5.46–65.61; p<0.001), inappropriate initial antibiotics (OR=4.15; 95%CI: 1.26 – 13.68; p=0.019); CRP> 150 mg/L (OR=5.06; 95%CI: 1.07 – 23.89; p=0.041), PCT> 2ng/mL (OR=8.45; 95%CI: 2.80 – 25.50; p=0.001). In multivariate regression analysis, septic shock and inappropriate initial antibiotics were identified as an independent predictors for mortality.  Conclusion: Appropriate initial antibiotics will reduce mortality, further studies are needed to evaluate the efficacy of vancomycin in the treatment of MRSA blood stream infection.