Meticillin-resistant Staphylococcus aureus isolated from foot ulcers in diabetic patients in a Chinese care hospital: risk factors for infection and prevalence
Meticillin-resistant Staphylococcus aureus isolated from foot ulcers in diabetic patients in a Chinese care hospital: risk factors for infection and prevalence
复制标题
从中国一家护理医院糖尿病患者足部溃疡中分离出的耐甲氧西林金黄色葡萄球菌：感染和患病率的危险因素。
DOI：
10.1099/jmm.0.020537-0
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发表时间：
2010-10-01
影响因子：
3
通讯作者：
Ye, Kuan-Ping
中科院分区：
文献类型：
--
作者：
Wang, Shao-Hua;Sun, Zi-Lin;Ye, Kuan-Ping
对118例（男：女，68：50）中国2型糖尿病足溃疡患者（瓦格纳3-5级）进行回顾性病例对照研究，以确定耐甲氧西林金黄色葡萄球菌（MRSA）感染的患病率和危险因素与原始社区或医院参数的关系。对溃疡标本进行革兰氏染色、需氧菌培养和抗菌药物敏感性试验。使用苯唑西林测试葡萄球菌属物种的甲氧西林抗性。S.金黄色葡萄球菌是糖尿病患者标本（160株分离株）中最常见的病原体（25.6%），金黄色葡萄球菌为MRSA（63.4%）。高比例的S。金黄色葡萄球菌分离株（65.4%）符合医院相关MRSA（HA-MRSA）感染的定义。溃疡的大小[调整的比值比（OR）1.61; 95%置信区间（CI）1.22-2.12]和骨髓炎（调整的OR 18.51，95% CI 2.50-137.21）是MRSA感染的独立预测因子。HA-MRSA组在年龄、糖尿病史和住院时间方面与社区相关MRSA组的分布有显著差异（均P <0.001）。神经病变、血管疾病（P=0.049）和骨髓炎（P=0.026）是HA-MRSA组中观察到的最常见的基础疾病。本研究有助于建立预防MRSA的出现，包括根据其原始或临床参数在中国糖尿病足溃疡人群中从不同来源获得的MRSA。
A retrospective case–control study of 118 (male : female, 68 : 50) Chinese type 2 diabetic patients with foot ulcers (Wagner's grade 3–5) was conducted to determine the prevalence and risk factors for meticillin-resistant Staphylococcus aureus (MRSA) infection in relation to the original community or hospital parameters. Ulcer specimens were processed for Gram staining, aerobic culture and antimicrobial susceptibility testing. Staphylococcus species were tested for meticillin resistance using oxacillin. S. aureus was the most frequent pathogen (25.6 %) in diabetic patient specimens (160 isolates), and a high proportion of S. aureus isolates were MRSA (63.4 %). A high percentage of S. aureus isolates (65.4 %) satisfied the definition for hospital-associated MRSA (HA-MRSA) infection. The size of ulcers [adjusted odds ratio (OR) 1.61; 95 % confidence interval (CI) 1.22–2.12] and osteomyelitis (adjusted OR 18.51, 95 % CI 2.50–137.21) were independent predictors of MRSA infection. The HA-MRSA group had a significantly different distribution from the community-associated MRSA group with respect to age, history of diabetes and length of hospital stay (all P0.001). Neuropathy, vascular disease (all P=0.049) and osteomyelitis (P=0.026) were the most common underlying conditions observed in the HA-MRSA group. This study contributes to the establishment of precautions against the emergence of MRSA including MRSA acquired from different sources among the Chinese population with diabetic foot ulcers based on their original or clinical parameters.