Evaluating the influence MRSA Co-infection on 28-day mortality among sepsis patients: insights from the MIMIC-IV database
BackgroundSepsis remains a leading cause of mortality in intensive care units (ICUs), with methicillin-resistant Staphylococcus aureus (MRSA) infections presenting significant treatment challenges. The impact of MRSA co-infection on sepsis outcomes necessitates further exploration.MethodsWe conducte...
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Frontiers Media S.A.
2025-03-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2025.1534107/full |
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| author | Yi-Chang Zhao Yi-Chang Zhao Jia-Kai Li Jia-Kai Li Yu-kun Zhang Yu-kun Zhang Zhi-Hua Sun Zhi-Hua Sun Rao Fu Rao Fu Bi-Kui Zhang Bi-Kui Zhang Miao Yan Miao Yan |
| author_facet | Yi-Chang Zhao Yi-Chang Zhao Jia-Kai Li Jia-Kai Li Yu-kun Zhang Yu-kun Zhang Zhi-Hua Sun Zhi-Hua Sun Rao Fu Rao Fu Bi-Kui Zhang Bi-Kui Zhang Miao Yan Miao Yan |
| author_sort | Yi-Chang Zhao |
| collection | DOAJ |
| description | BackgroundSepsis remains a leading cause of mortality in intensive care units (ICUs), with methicillin-resistant Staphylococcus aureus (MRSA) infections presenting significant treatment challenges. The impact of MRSA co-infection on sepsis outcomes necessitates further exploration.MethodsWe conducted a retrospective observational cohort study using the Medical Information Mart for Critical Care IV (MIMIC-IV-2.2) database. This cohort study included sepsis patients, scrutinizing baseline characteristics, MRSA co-infection, antimicrobial susceptibility, and their relations to mortality through Cox regression and Kaplan-Meier analyses.ResultsAmong 453 sepsis patients analyzed, significant baseline characteristic differences were observed between survivors (N = 324) and non-survivors (N = 129). Notably, non-survivors were older (70.52 ± 14.95 vs. 64.42 ± 16.05, P < 0.001), had higher lactate levels (2.82 ± 1.76 vs. 2.04 ± 1.56 mmol/L, P < 0.001), and higher SOFA scores (8.36 ± 4.18 vs. 6.26 ± 3.65, P < 0.001). Cox regression highlighted SOFA score (HR = 1.122, P = 0.003), body temperature (HR = 0.825, P = 0.048), and age (HR = 1.030, P = 0.004) as significant predictors of 28-day mortality. MRSA co-infection was found in 98.7% of cases without a significant effect on 28-day mortality (P = 0.9). However, sensitivity to cephalosporins, meropenem, and piperacillin/tazobactam was associated with reduced mortality. The area under the ROC curve for the combined model of age, SOFA, and body temperature was 0.73, indicating a moderate predictive value for 28-day mortality.ConclusionWhile MRSA co-infection’s direct impact on 28-day sepsis mortality is minimal, antimicrobial sensitivity, especially to cephalosporins, meropenem, and piperacillin/tazobactam, plays a critical role in improving outcomes, underscoring the importance of antimicrobial stewardship and personalized treatment strategies in sepsis care. |
| format | Article |
| id | doaj-art-b849bbcccd5c4c5b8789c5fca6512e6e |
| institution | DOAJ |
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| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
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| spelling | doaj-art-b849bbcccd5c4c5b8789c5fca6512e6e2025-08-20T02:47:45ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-03-011610.3389/fphar.2025.15341071534107Evaluating the influence MRSA Co-infection on 28-day mortality among sepsis patients: insights from the MIMIC-IV databaseYi-Chang Zhao0Yi-Chang Zhao1Jia-Kai Li2Jia-Kai Li3Yu-kun Zhang4Yu-kun Zhang5Zhi-Hua Sun6Zhi-Hua Sun7Rao Fu8Rao Fu9Bi-Kui Zhang10Bi-Kui Zhang11Miao Yan12Miao Yan13Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, Hunan, ChinaInternational Research Center for Precision Medicine, Transformative Technology and SoftwareServices, Changsha, Hunan, ChinaDepartment of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, Hunan, ChinaInternational Research Center for Precision Medicine, Transformative Technology and SoftwareServices, Changsha, Hunan, ChinaDepartment of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, Hunan, ChinaXiangya School of Medicine, Central South University, School of Pharmacy, Changsha, Hunan, ChinaInternational Research Center for Precision Medicine, Transformative Technology and SoftwareServices, Changsha, Hunan, ChinaSchool of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, ChinaDepartment of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, Hunan, ChinaInternational Research Center for Precision Medicine, Transformative Technology and SoftwareServices, Changsha, Hunan, ChinaDepartment of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, Hunan, ChinaInternational Research Center for Precision Medicine, Transformative Technology and SoftwareServices, Changsha, Hunan, ChinaDepartment of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, Hunan, ChinaInternational Research Center for Precision Medicine, Transformative Technology and SoftwareServices, Changsha, Hunan, ChinaBackgroundSepsis remains a leading cause of mortality in intensive care units (ICUs), with methicillin-resistant Staphylococcus aureus (MRSA) infections presenting significant treatment challenges. The impact of MRSA co-infection on sepsis outcomes necessitates further exploration.MethodsWe conducted a retrospective observational cohort study using the Medical Information Mart for Critical Care IV (MIMIC-IV-2.2) database. This cohort study included sepsis patients, scrutinizing baseline characteristics, MRSA co-infection, antimicrobial susceptibility, and their relations to mortality through Cox regression and Kaplan-Meier analyses.ResultsAmong 453 sepsis patients analyzed, significant baseline characteristic differences were observed between survivors (N = 324) and non-survivors (N = 129). Notably, non-survivors were older (70.52 ± 14.95 vs. 64.42 ± 16.05, P < 0.001), had higher lactate levels (2.82 ± 1.76 vs. 2.04 ± 1.56 mmol/L, P < 0.001), and higher SOFA scores (8.36 ± 4.18 vs. 6.26 ± 3.65, P < 0.001). Cox regression highlighted SOFA score (HR = 1.122, P = 0.003), body temperature (HR = 0.825, P = 0.048), and age (HR = 1.030, P = 0.004) as significant predictors of 28-day mortality. MRSA co-infection was found in 98.7% of cases without a significant effect on 28-day mortality (P = 0.9). However, sensitivity to cephalosporins, meropenem, and piperacillin/tazobactam was associated with reduced mortality. The area under the ROC curve for the combined model of age, SOFA, and body temperature was 0.73, indicating a moderate predictive value for 28-day mortality.ConclusionWhile MRSA co-infection’s direct impact on 28-day sepsis mortality is minimal, antimicrobial sensitivity, especially to cephalosporins, meropenem, and piperacillin/tazobactam, plays a critical role in improving outcomes, underscoring the importance of antimicrobial stewardship and personalized treatment strategies in sepsis care.https://www.frontiersin.org/articles/10.3389/fphar.2025.1534107/fullMRSAantimicrobial susceptibilitysepsis28-day mortalityMIMIC database |
| spellingShingle | Yi-Chang Zhao Yi-Chang Zhao Jia-Kai Li Jia-Kai Li Yu-kun Zhang Yu-kun Zhang Zhi-Hua Sun Zhi-Hua Sun Rao Fu Rao Fu Bi-Kui Zhang Bi-Kui Zhang Miao Yan Miao Yan Evaluating the influence MRSA Co-infection on 28-day mortality among sepsis patients: insights from the MIMIC-IV database Frontiers in Pharmacology MRSA antimicrobial susceptibility sepsis 28-day mortality MIMIC database |
| title | Evaluating the influence MRSA Co-infection on 28-day mortality among sepsis patients: insights from the MIMIC-IV database |
| title_full | Evaluating the influence MRSA Co-infection on 28-day mortality among sepsis patients: insights from the MIMIC-IV database |
| title_fullStr | Evaluating the influence MRSA Co-infection on 28-day mortality among sepsis patients: insights from the MIMIC-IV database |
| title_full_unstemmed | Evaluating the influence MRSA Co-infection on 28-day mortality among sepsis patients: insights from the MIMIC-IV database |
| title_short | Evaluating the influence MRSA Co-infection on 28-day mortality among sepsis patients: insights from the MIMIC-IV database |
| title_sort | evaluating the influence mrsa co infection on 28 day mortality among sepsis patients insights from the mimic iv database |
| topic | MRSA antimicrobial susceptibility sepsis 28-day mortality MIMIC database |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2025.1534107/full |
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