Risk factors for methicillin-resistant Staphylococcus aureus carriage among residents in 7 nursing homes in Shanghai, China
Risk factors for methicillin-resistant Staphylococcus aureus carriage among residents in 7 nursing homes in Shanghai, China
复制标题
上海7家养老院居民携带耐甲氧西林金黄色葡萄球菌的危险因素
DOI：
10.1016/j.ajic.2016.01.032
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发表时间：
2016-07-01
影响因子：
4.9
通讯作者：
Han, Li-Zhong
中科院分区：
文献类型：
--
作者：
Gu, Fei-Fei;Zhang, Ji;Han, Li-Zhong
背景资料：养老院居民是耐甲氧西林金黄色葡萄球菌（MRSA）携带的高危人群，但上海市养老院居民MRSA携带情况的相关数据很少。本研究的目的是确定的患病率和危险因素MRSA携带在养老院居民在上海，China.Methods：四百四十三名居民从7个养老院在上海，中国，参加了这项研究，鼻和腋窝拭子，从这些居民获得。分离时进行金黄色葡萄球菌的实验室鉴定和抗菌药物敏感性试验。结果：在443名参与调查的居民中，金黄色葡萄球菌和耐甲氧西林金黄色葡萄球菌分别有99人（22.3%）和45人（10.2%）定植。既往住院（比值比[OR]，2.564; 95%置信区间[CI]，1.214-5.415; P = 0.014），存在侵入性器械（OR，3.455; 95% CI，1.678-7.113; P = .001），氯霉素治疗（OR，7.672; 95%CI，1.807-32.580; P = .006）和大环内酯类药物治疗（OR，2.796; 95%CI，1.056-7.403; P = .038）是MRSA定植的独立危险因素。每月低支出和不太好的卫生条件也增加了MRSA定植的风险。结论：我们的研究表明，养老院是MRSA的重要水库。实施感染控制策略必须给予高度重视，在养老院，以打击高患病率的MRSA，并增加便利性和可行性，也应该实现这些控制策略的MRSA定植。(C)2016由Elsevier Inc.出版代表感染控制和流行病学专业人员协会，
Background: Nursing home residents are a population at risk for methicillin-resistant Staphylococcus aureus (MRSA) carriage, but few data about MRSA in this setting in Shanghai are available. The aim of this study is to determine the prevalence and risk factors for MRSA carriage in nursing home residents in Shanghai, China.Methods: Four hundred forty-three residents from 7 nursing homes in Shanghai, China, participated in this study; nasal and axillary swabs were obtained from these residents. Laboratory identification for S aureus and antimicrobial susceptibility testing were performed when isolated. Data, including individual resident characteristics and nursing home characteristics, were collected and analyzed.Results: Of the 443 participating residents, 99 (22.3%) and 45 (10.2%) residents were colonized by S aureus and MRSA, respectively. Previous hospitalization (odds ratio [OR], 2.564; 95% confidence interval [CI], 1.214-5.415; P = .014), presence of an invasive device (OR, 3.455; 95% CI, 1.678-7.113; P = .001), chloramphenicol therapy (OR, 7.672; 95% CI, 1.807-32.580; P = .006), and macrolides therapy (OR, 2.796; 95% CI, 1.056-7.403; P = .038) were independent risk factors for MRSA colonization. Low expenditure per month and less good sanitary condition also increased the risk for MRSA colonization.Conclusions: Our study suggests that nursing homes are significant reservoirs for MRSA. Implementation of infection control strategies must be given high priority in nursing homes to fight the high prevalence of MRSA, and increased convenience and feasibility should also be realized with these control strategies for MRSA colonization. (C) 2016 Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.