Community-acquired methicillin-resistant Staphylococcus aureus:: A meta-analysis of prevalence and risk factors
Community-acquired methicillin-resistant Staphylococcus aureus:: A meta-analysis of prevalence and risk factors
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DOI：
10.1086/345436
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发表时间：
2003-01-15
影响因子：
11.8
通讯作者：
Calfee, DP
中科院分区：
文献类型：
--
作者：
Salgado, CD;Farr, BM;Calfee, DP
报告表明，在没有医疗保健相关风险的人群中，耐甲氧西林金黄色葡萄球菌（MRSA）的携带率有所增加。对报告住院患者MRSA分离株中社区获得性MRSA（CA-MRSA）患病率或社区成员中MRSA定植患病率的研究进行了荟萃分析。在27项回顾性研究和5项前瞻性研究中，CA-MRSA在医院MRSA中的患病率分别为30.2%和37.3%; 85%的CA-MRSA患者具有大于或等于1的医疗保健相关风险。社区成员中合并的MRSA定植率为1.3%（95%置信区间[Cl]，1.04%-1.53%），但研究人群之间存在显著异质性。从卫生保健机构获得样本的社区成员比从卫生保健机构以外获得样本的社区成员更有可能携带MRSA（相对风险，2.35; 95%CI，1.56-3.53）。在排除与医疗保健接触者的研究中，MRSA患病率为0.2%。此外，大多数CA-MRSA患者的健康相关风险大于或等于1，这表明MRSA在无风险人群中的患病率仍然较低（小于或等于0.24%）。有效控制MRSA在整个社区的传播可能需要有效控制MRSA的院内传播。
Reports suggest that carriage of methicillin-resistant Staphylococcus aureus (MRSA) among persons without health care-associated risks has increased. A meta-analysis of studies reporting the prevalence of community-acquired MRSA (CA-MRSA) among MRSA isolates from hospitalized patients or the prevalence of MRSA colonization among community members was conducted. The CA-MRSA prevalence among hospital MRSA was 30.2% in 27 retrospective studies and 37.3% in 5 prospective studies; 85% of all patients with CA-MRSA had greater than or equal to1 health care-associated risk. The pooled MRSA colonization rate among community members was 1.3% (95% confidence interval [Cl], 1.04%-1.53%), but there was significant heterogeneity among study populations. Community members from whom samples were obtained in health care facilities were more likely to be carrying MRSA than were community members from whom samples were obtained outside of the health care setting (relative risk, 2.35; 95% Cl, 1.56-3.53). Among studies that excluded persons with health care contacts, the MRSA prevalence was 0.2%. Moreover, most persons with CA-MRSA had greater than or equal to1 health care-associated risk, which suggests that the prevalence of MRSA among persons without risks remains low (less than or equal to0.24%). Effective control of dissemination of MRSA throughout the community likely will require effective control of nosocomial MRSA transmission.