There is limited data on persistent bacteremia (PB) caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). Here, we aimed to investigate the clinical and microbiological characteristics of PB caused by the major CA-MRSA strain in Korea (ST72-SCCmecIV). All adult patients with S. aureus bacteremia were prospectively investigated from August 2008 to December 2018. Patients with ST72 MRSA bacteremia were included in the study. Patients were stratified into the PB group (defined as positive blood cultures for ≥ 3 days) and short bacteremia (SB) group. A total of 291 patients were included, comprising 115 (39.5%) with PB and 176 (60.5%) with SB. Although the 30-day mortality did not differ between PB and SB, recurrent bacteremia within 12 weeks was significantly more common in PB (8.7% vs 1.7%; P = 0.01). Multivariate analysis showed risk factors of PB were liver cirrhosis (adjusted odds ratio [aOR], 3.27; 95% confidence interval [CI], 1.50–7.12), infective endocarditis (aOR, 7.13; 95% CI, 1.37–37.12), bone and joint infections (aOR, 3.76; 95% CI, 1.62–8.77), C-reactive protein ≥ 10 mg/dL (aOR, 2.20; 95% CI, 1.22–3.95), metastatic infection (aOR, 7.35; 95% CI, 3.53–15.29), and agr dysfunction (aOR, 2.47; 95% CI, 1.05–5.81). PB occurred in approximately 40% of bacteremia caused by ST72 MRSA with a significantly higher recurrence rate. Patients with risk factors of PB, including liver cirrhosis, high initial CRP, infective endocarditis, or bone and joint infections, might require early aggressive treatment.

关于社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)引起的持续性菌血症 (PB) 的数据有限。在这里，我们旨在研究由韩国主要 CA-MRSA 菌株（ST72-SCC mec IV）引起的 PB 的临床和微生物学特征。所有成年S患者。金黄色葡萄球菌2008 年 8 月至 2018 年 12 月对菌血症进行了前瞻性调查。本研究包括 ST72 MRSA 菌血症患者。患者被分为PB组（定义为阳性血培养≥3天）和短期菌血症（SB）组。共纳入 291 名患者，其中 115 名 (39.5%) 患有 PB，176 名 (60.5%) 患有 SB。尽管 PB 和 SB 的 30 天死亡率没有差异，但 12 周内复发性菌血症在 PB 中明显更常见（8.7% vs 1.7%；P = 0.01）。多变量分析显示 PB 的危险因素是肝硬化（调整后的比值比 [aOR]，3.27；95% 置信区间 [CI]，1.50–7.12）、感染性心内膜炎（aOR，7.13；95% CI，1.37–37.12）、骨和关节感染（aOR，3.76；95% CI，1.62–8.77），C 反应蛋白 ≥ 10 mg/dL（aOR，2.20；95% CI，1.22–3.95），转移性感染（aOR，7.35；95% CI） , 3.53–15.29) 和agr功能障碍 (aOR, 2.47; 95% CI, 1.05–5.81)。PB 发生在大约 40% 的 ST72 MRSA 引起的菌血症中，复发率显着更高。具有 PB 危险因素的患者，包括肝硬化、初始 CRP 高、感染性心内膜炎或骨关节感染，可能需要早期积极治疗。