Bacterial Infections in Neonates Following Mupirocin-Based MRSA Decolonization: A Multicenter Cohort Study.
Bacterial Infections in Neonates Following Mupirocin-Based MRSA Decolonization: A Multicenter Cohort Study.
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基于穆匹洛罗金的MRSA非殖民化后，新生儿的细菌感染：一项多中心队列研究。
DOI：
10.1017/ice.2017.108
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发表时间：
2017-08
影响因子：
4.5
通讯作者：
Milstone AM
中科院分区：
文献类型：
--
作者：
Pierce R;Bryant K;Elward A;Lessler J;Milstone AM
描述鼻内莫匹罗星对金黄色葡萄球菌去殖民化后的感染风险。多中心、回顾性队列研究。美国三家城市医院的三级护理新生儿重症监护室（NICU）。床型范围：45 - 100。从2007年1月至2014年12月的NICU入院中确定了MRSA定植的新生儿，在此期间，采用了针对性的非殖民化策略进行MRSA控制。在两项至事件发生时间分析中，从首次MRSA阳性监测筛查之日起观察MRSA定植新生儿，直至1）无菌培养或出院时首次出现新型革兰氏阳性球菌和2）无菌培养或出院时首次出现新型革兰氏阴性杆菌。莫匹罗星暴露被视为随时间变化。从入住现场NICU的16，144名新生儿中，共发现522名感染耐甲氧西林金黄色葡萄球菌的新生儿。在MRSA定植的新生儿中，384例（74%）接受莫匹罗星治疗。从阳性培养到莫匹罗星治疗的平均时间为3.5天（sd = 7.2天）。暴露于莫匹罗星的新生儿与未暴露于莫匹罗星的新生儿相比，革兰氏阳性球菌感染的校正风险低64%（HR = 0.36，95% CI：0.17 - 0.76），而暴露于莫匹罗星的新生儿与未暴露于莫匹罗星的新生儿相比，革兰氏阴性杆菌感染的校正风险比为1.05（95% CI：0.42 - 2.62）。在MRSA定植新生儿的多中心队列中，基于莫匹罗星的去殖民化治疗似乎降低了选定革兰氏阳性微生物感染的风险，如预期的那样，并且与莫匹罗星活性谱未涵盖的微生物后续感染的风险无显著相关性。
To characterize the risk of infection after Staphylococcus aureus decolonization with intranasal mupirocin. Multicenter, retrospective cohort study. Tertiary care neonatal intensive care units (NICUs) from three urban hospitals in US. Bed size range: 45–100. MRSA-colonized neonates were identified from NICU admissions occurring from January 2007–December 2014, during which a targeted decolonization strategy was used for MRSA control. In two time-to-event analyses, MRSA-colonized neonates were observed from date of first MRSA positive surveillance screen until 1) first occurrence of novel gram-positive cocci in sterile culture or discharge and 2) first occurrence of novel gram-negative bacilli in sterile culture or discharge. Mupirocin exposure was treated as time varying. A total of 522 MRSA-colonized neonates were identified from 16,144 neonates admitted to site NICUs. Of the MRSA-colonized neonates, 384 (74%) received mupirocin. Average time from positive culture to mupirocin treatment was 3.5 days (sd=7.2 days). The adjusted hazard of gram-positive cocci infection was 64% less among mupirocin-exposed versus mupirocin-unexposed neonates (HR=0.36, 95% CI: 0.17–0.76), while the adjusted hazard ratio of gram-negative bacilli infection comparing mupirocin-exposed and -unexposed neonates was 1.05 (95% CI: 0.42–2.62). In this multi-centered cohort of MRSA-colonized neonates, mupirocin-based decolonization treatment appeared to decrease the risk of infection with select gram-positive organisms, as intended, and was not significantly associated with risk of subsequent infections with organisms not covered by mupirocin’s spectrum of activity.
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一个尺寸不符合全部：为什么要预防耐甲氧西林的金黄色葡萄球菌定植和成人重症监护病房感染的普遍非殖民化策略可能不适合新生儿重症监护病房。
影响因子：
2.9
作者：
Nelson, M. U.;Bizzarro, M. J.;Dembry, L. M.;Baltimore, R. S.;Gallagher, P. G.
通讯作者：
Gallagher, P. G.
DOI：
10.1126/science.1224203
发表时间：
2012-06-08
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Costello EK;Stagaman K;Dethlefsen L;Bohannan BJ;Relman DA
通讯作者：
Relman DA
影响因子：
4.9
作者：
SUTHERLAND, R;BOON, RJ;WHITE, AR
通讯作者：
WHITE, AR
影响因子：
13.2
作者：
PEREZFONTAN, M;GARCIAFALCON, T;MONCALIAN, J
通讯作者：
MONCALIAN, J
DOI：
10.1073/pnas.1002601107
发表时间：
2010-06-29
影响因子：
11.1
作者：
Dominguez-Bello, Maria G.;Costello, Elizabeth K.;Knight, Rob
通讯作者：
Knight, Rob