Prevalence of methicillin-resistant Staphylococcus aureus in skin and soft tissue infections in patients presenting to Canadian emergency departments
Prevalence of methicillin-resistant Staphylococcus aureus in skin and soft tissue infections in patients presenting to Canadian emergency departments
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DOI：
10.2310/8000.2013.130798
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发表时间：
2013-05-01
影响因子：
2.4
通讯作者：
Katz, Kevin
中科院分区：
文献类型：
--
作者：
Borgundvaag, Bjug;Wil Ng;Katz, Kevin
背景资料：社区相关耐甲氧西林金黄色葡萄球菌（MRSA）是全球皮肤和软组织感染（SSTI）的常见原因。MRSA在加拿大SSTI中的患病率尚未得到很好的描述。美国的研究表明MRSA的流行存在显著的地理差异。本研究的特点是MRSA的地理流行率和微生物学在加拿大急诊科与SSTIs.Methods：采用前瞻性，观察性设计，我们招募了急性化脓性SSTIs的患者提出17家医院急诊科和2个社区卫生中心（跨越6个加拿大省）之间的2008年7月1日，2009年4月30日。合格的患者是那些伤口培养生长S。金黄色。MRSA分离株的特点是抗菌药物敏感性试验和脉冲场凝胶电泳。所有患者均接受结构化图表审计，通过电话联系伤口拭子生长MRSA的患者，以收集有关MRSA感染风险因素、病史和结局的详细信息。金葡菌阳性病例中，431例（32%）生长MRSA，922例（68%）伤口生长甲氧西林敏感性S。金黄色。我们观察到显着的变化，MRSA的患病率（11-100%）和社区相关菌株的MRSA的比例（0-100%）在我们的研究站点，与MRSA的患病率显着较高的西加拿大。解释：MRSA继续出现在加拿大各地，和MRSA的患病率在整个加拿大的SSTI是可变的，高于先前的预期。
Background: Community-associated methicillin-resistant Staphylococcus aureus (MRSA) is an increasingly common cause of skin and soft tissue infection (SSTI) worldwide. The prevalence of MRSA in SSTIs across Canada has not been well described. Studies in the United States have shown significant geographic variability in the prevalence of MRSA. This study characterizes the geographic prevalence and microbiology of MRSA in patients presenting to Canadian emergency departments with SSTIs.Methods: Using a prospective, observational design, we enrolled patients with acute purulent SSTIs presenting to 17 hospital emergency departments and 2 community health centres (spanning 6 Canadian provinces) between July 1, 2008, and April 30, 2009. Eligible patients were those whose wound cultures grew S. aureus. MRSA isolates were characterized by antimicrobial susceptibility testing and pulsed-field gel electrophoresis. All patients were subjected to a structured chart audit, and patients whose wound swabs grew MRSA were contacted by telephone to gather detailed information regarding risk factors for MRSA infection, history of illness, and outcomes.Results: Of the 1,353 S. aureus-positive encounters recorded, 431 (32%) grew MRSA and 922 (68%) wounds grew methicillin-susceptible S. aureus. We observed significant variation in both the prevalence of MRSA (11-100%) and the proportion of community-associated strains of MRSA (0-100%) across our study sites, with a significantly higher prevalence of MRSA in western Canada.Interpretation: MRSA continues to emerge across Canada, and the prevalence of MRSA in SSTIs across Canada is variable and higher than previously expected.