美国引起住院病人内源性眼内炎的感染病原体的地区差异：全国分析。

IF 4.4 Q1 OPHTHALMOLOGY

Ophthalmology. Retina Pub Date : 2024-09-01 DOI:10.1016/j.oret.2024.03.012

{"title":"美国引起住院病人内源性眼内炎的感染病原体的地区差异：全国分析。","authors":"","doi":"10.1016/j.oret.2024.03.012","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To describe regional variation in microbes causing infectious endogenous endophthalmitis (EE) in the United States.</p></div><div><h3>Design</h3><p>This is a retrospective, national database analysis utilizing the 2002–2014 National Inpatient Sample database.</p></div><div><h3>Subjects</h3><p>Using the International Classification of Disease 9 codes, we identified cases with EE. Cases were stratified regionally into Northeast, South, West, or Midwest.</p></div><div><h3>Methods</h3><p>Unadjusted chi-square analysis followed by adjusted multivariate logistic regression was performed to evaluate variation in demographic factors, comorbidities using the Elixhauser Comorbidity Index (ECI), microbial variation, mortality, and use of vitrectomy or enucleation by region.</p></div><div><h3>Main Outcome Measures</h3><p>Proportion of microbes, mortality, and vitrectomy by region in addition to factors with significant odds ratios for mortality and for in-hospital vitrectomy.</p></div><div><h3>Results</h3><p>A total of 10 912 patients with infectious EE were identified, with 2063 cases in the Northeast (18.9%), 2145 cases in the Midwest (19.7%), 4134 cases in the South (37.9%), and 2570 cases in the West (23.6%). Chi-square analysis indicated significant regional variation in patient demographics, microbes causing the infection, ECI, mortality, and surgical intervention. The 4 most common microbes for all regions were methicillin-sensitive <em>Staphylococcus aureus</em> (MSSA), <em>Streptococcus</em>, <em>Candida</em>, and methicillin-resistant <em>Staphylococcus aureus</em>. Methicillin-sensitive <em>S. aureus</em> was the most common cause of EE in all regions, although the proportion of MSSA infection did not significantly vary by region (<em>P</em> = 0.03). Further, there was significant regional variation in the proportion of other microbes causing the infection (<em>P</em> < 0.001). Higher rates of vitrectomies were seen in the South and Midwest regions than that in the Northeast and West (<em>P</em> = 0.04).</p></div><div><h3>Conclusions</h3><p>Regional variation exists in the infectious microbes causing EE. Further studies are needed to elucidate the etiology of these variations.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":null,"pages":null},"PeriodicalIF":4.4000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468653024001167/pdfft?md5=a93e88051e9be4d916a362dbe95a4482&pid=1-s2.0-S2468653024001167-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Regional Variation of Infectious Agents Causing Endogenous Endophthalmitis in the United States\",\"authors\":\"\",\"doi\":\"10.1016/j.oret.2024.03.012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To describe regional variation in microbes causing infectious endogenous endophthalmitis (EE) in the United States.</p></div><div><h3>Design</h3><p>This is a retrospective, national database analysis utilizing the 2002–2014 National Inpatient Sample database.</p></div><div><h3>Subjects</h3><p>Using the International Classification of Disease 9 codes, we identified cases with EE. Cases were stratified regionally into Northeast, South, West, or Midwest.</p></div><div><h3>Methods</h3><p>Unadjusted chi-square analysis followed by adjusted multivariate logistic regression was performed to evaluate variation in demographic factors, comorbidities using the Elixhauser Comorbidity Index (ECI), microbial variation, mortality, and use of vitrectomy or enucleation by region.</p></div><div><h3>Main Outcome Measures</h3><p>Proportion of microbes, mortality, and vitrectomy by region in addition to factors with significant odds ratios for mortality and for in-hospital vitrectomy.</p></div><div><h3>Results</h3><p>A total of 10 912 patients with infectious EE were identified, with 2063 cases in the Northeast (18.9%), 2145 cases in the Midwest (19.7%), 4134 cases in the South (37.9%), and 2570 cases in the West (23.6%). Chi-square analysis indicated significant regional variation in patient demographics, microbes causing the infection, ECI, mortality, and surgical intervention. The 4 most common microbes for all regions were methicillin-sensitive <em>Staphylococcus aureus</em> (MSSA), <em>Streptococcus</em>, <em>Candida</em>, and methicillin-resistant <em>Staphylococcus aureus</em>. Methicillin-sensitive <em>S. aureus</em> was the most common cause of EE in all regions, although the proportion of MSSA infection did not significantly vary by region (<em>P</em> = 0.03). Further, there was significant regional variation in the proportion of other microbes causing the infection (<em>P</em> < 0.001). Higher rates of vitrectomies were seen in the South and Midwest regions than that in the Northeast and West (<em>P</em> = 0.04).</p></div><div><h3>Conclusions</h3><p>Regional variation exists in the infectious microbes causing EE. Further studies are needed to elucidate the etiology of these variations.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>\",\"PeriodicalId\":19501,\"journal\":{\"name\":\"Ophthalmology. Retina\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2468653024001167/pdfft?md5=a93e88051e9be4d916a362dbe95a4482&pid=1-s2.0-S2468653024001167-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ophthalmology. Retina\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2468653024001167\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmology. Retina","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2468653024001167","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目的：描述美国引起传染性眼内炎（EE）的微生物的地区差异：描述美国导致传染性内源性眼内炎（EE）的微生物的地区差异：这是一项回顾性全国数据库分析，利用的是 2002-2014 年全国住院病人抽样（NIS）数据库：利用国际疾病分类 9 (ICD-9) 代码，我们确定了 EE 病例。病例按地区分为东北部、南部、西部或中西部：方法：进行未调整的卡方分析，然后进行调整后的多变量逻辑回归，以评估各地区人口统计学因素、使用埃利克豪斯发病率指数（ECI）的合并症、微生物变异、死亡率以及玻璃体切除术或去核术的使用情况：主要结果测量指标：各地区微生物比例、死亡率和玻璃体切除术，以及死亡率和院内玻璃体切除术的显著几率比：共发现 10,912 例感染性 EE 患者，其中东北部 2,063 例（18.9%），中西部 2,145 例（19.7%），南部 4,134 例（37.9%），西部 2,570 例（23.6%）。Chi-square分析表明，各地区在患者人口统计学、引起感染的微生物、Elixhauser综合指数、死亡率和手术干预等方面存在显著差异。所有地区最常见的四种微生物是甲氧西林敏感金黄色葡萄球菌（MSSA）、链球菌、念珠菌和耐甲氧西林金黄色葡萄球菌。在所有地区，耐甲氧西林金黄色葡萄球菌都是导致 EE 的最常见原因，但不同地区的耐甲氧西林金黄色葡萄球菌感染比例差异不大（P=0.027）。此外，其他微生物引起感染的比例也存在明显的地区差异（p 结论：引起 EE 的感染性微生物存在地区差异。需要进一步研究以阐明这些差异的病因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Regional Variation of Infectious Agents Causing Endogenous Endophthalmitis in the United States

Objective

To describe regional variation in microbes causing infectious endogenous endophthalmitis (EE) in the United States.

Design

This is a retrospective, national database analysis utilizing the 2002–2014 National Inpatient Sample database.

Subjects

Using the International Classification of Disease 9 codes, we identified cases with EE. Cases were stratified regionally into Northeast, South, West, or Midwest.

Methods

Unadjusted chi-square analysis followed by adjusted multivariate logistic regression was performed to evaluate variation in demographic factors, comorbidities using the Elixhauser Comorbidity Index (ECI), microbial variation, mortality, and use of vitrectomy or enucleation by region.

Main Outcome Measures

Proportion of microbes, mortality, and vitrectomy by region in addition to factors with significant odds ratios for mortality and for in-hospital vitrectomy.

Results

A total of 10 912 patients with infectious EE were identified, with 2063 cases in the Northeast (18.9%), 2145 cases in the Midwest (19.7%), 4134 cases in the South (37.9%), and 2570 cases in the West (23.6%). Chi-square analysis indicated significant regional variation in patient demographics, microbes causing the infection, ECI, mortality, and surgical intervention. The 4 most common microbes for all regions were methicillin-sensitive Staphylococcus aureus (MSSA), Streptococcus, Candida, and methicillin-resistant Staphylococcus aureus. Methicillin-sensitive S. aureus was the most common cause of EE in all regions, although the proportion of MSSA infection did not significantly vary by region (P = 0.03). Further, there was significant regional variation in the proportion of other microbes causing the infection (P < 0.001). Higher rates of vitrectomies were seen in the South and Midwest regions than that in the Northeast and West (P = 0.04).