Microbiology of skin and soft tissue infections in the age of community-acquired methicillin-resistant Staphylococcus aureus
Microbiology of skin and soft tissue infections in the age of community-acquired methicillin-resistant Staphylococcus aureus
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DOI：
10.1016/j.diagmicrobio.2013.02.020
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发表时间：
2013-05-01
影响因子：
2.9
通讯作者：
Baxter, Roger
中科院分区：
文献类型：
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作者：
Ray, G. Thomas;Suaya, Jose A.;Baxter, Roger
本研究的目的是确定一般人群中皮肤和软组织感染（SSTI）的病因，并描述患者特征、SSTI类型、微生物检测频率以及耐甲氧西林金黄色葡萄球菌（MRSA）随时间推移的作用。使用电子数据库，我们确定了SSTI事件和微生物测试的成员之间的一个大型美国健康计划。在2006年至2009年期间，确定了648699次SSTI发作，其中23%有标本，其中15%是血液。在58%的SSTI培养物中鉴定出病原体。S.金黄色葡萄球菌是最常见的病原体（阳性培养物的80%）。S的一半。金黄色葡萄球菌分离株是MRSA。血培养阳性的蜂窝织炎和脓肿患者中，21%为甲氧西林敏感的沙门氏菌。金黄色葡萄球菌，16%是MRSA，21%是β-溶血性链球菌，28%是革兰氏阴性菌。1998年至2009年，获得培养物的SSTI百分比从11%增加到24%。在培养确认病原体的SSTI事件中，MRSA从1998年的5%增加到2001年的9%，2005年的42%，2009年下降到37%。这些数据可以为SSTI治疗的抗生素选择提供信息。(C)2013 Elsevier Inc. All rights reserved.
The objectives of this study were to determine the etiology of skin and soft-tissue infections (SSTIs) in a general population, and to describe patient characteristics, SSTI types, frequency of microbiologic testing, and the role of methicillin-resistant Staphylococcus aureus (MRSA) over time. Using electronic databases, we identified SSTI episodes and microbiologic testing among members of a large US health plan. Between 2006 and 2009, 648699 SSTI episodes were identified, of which 23% had a specimen, of which 15% were blood. A pathogen was identified in 58% of SSTI cultures. S. aureus was the most common pathogen (80% of positive cultures). Half of S. aureus isolates were MRSA. Among cellulitis and abscess episodes with a positive blood culture, 21% were methicillin-sensitive S. aureus, 16% were MRSA, 21% were beta-hemolytic streptococci and 28% were Gram negative bacteria. Between 1998 and 2009, the percentage of SSTIs for which a culture was obtained increased from 11% to 24%. In SSTI episodes with a culture-confirmed pathogen, MRSA increased from 5% in 1998 to 9% in 2001 to 42% in 2005, decreasing to 37% in 2009. These data can inform the choice of antibiotics for treatment of SSTIs. (C) 2013 Elsevier Inc. All rights reserved.