Duration of colonization by methicillin-resistant Staphylococcus aureus after hospital discharge and risk factors for prolonged carriage
Duration of colonization by methicillin-resistant Staphylococcus aureus after hospital discharge and risk factors for prolonged carriage
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DOI：
10.1086/320151
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发表时间：
2001-05-15
影响因子：
11.8
通讯作者：
Lucet, JC
中科院分区：
文献类型：
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作者：
Scanvic, A;Denic, L;Lucet, JC
为了调查耐甲氧西林金黄色葡萄球菌 (MRSA) 的持续携带情况，我们对重新入院的既往携带者进行了为期 10 个月的 MRSA 携带前瞻性研究。除了医生要求的诊断标本外，入院后 3 天内还采集了 4 份筛查标本，其中 2 份来自皮肤，2 份来自鼻孔。在我们研究的 78 名患者中，31 名 (40%) 是 MRSA 的持续携带者，估计 MRSA 清除的中位时间为 8.5 个月。在多变量分析中，与持续携带显着相关的唯一因素是再入院时皮肤出现破损（优势比，4.34；P = .004）；然而，从慢性病护理机构入院的情况却存在趋势（比值比，3.65；P = .06）。我们的数据证实，出院后可能会出现长时间的 MRSA 携带，支持以前 MRSA 阳性患者重新入院时对 MRSA 进行常规筛查，并建议如果这些患者皮肤有破损，应保持特别高的 MRSA 携带怀疑指数。
To investigate persistent carriage of methicillin-resistant Staphylococcus aureus (MRSA), we conducted a prospective 10-month study of MRSA carriage in previous carriers who were readmitted to our hospital. Four screening specimens, 2 from the skin and 2 from the nares, were obtained within 3 days after admission, in addition to diagnostic specimens requested by physicians. Of the 78 patients included in our study, 31 (40%) were persistent carriers of MRSA, with an estimated median time of 8.5 months to MRSA clearance. In the multivariate analysis, the only factor significantly associated with persistent carriage was the presence of a break in the skin at readmission (odds ratio, 4.34; P = .004); however, a trend was found for admission from a chronic-care institution (odds ratio, 3.65; P = .06). Our data confirm that prolonged carriage of MRSA can occur after hospital discharge, support routine screening for MRSA at readmission of previously MRSA-positive patients, and suggest that a particularly high index of suspicion for MRSA carriage should be maintained if these patients have a break in the skin.