Risk of infection and death due to methicillin-resistant Staphylococcus aureus in long-term carriers
Risk of infection and death due to methicillin-resistant Staphylococcus aureus in long-term carriers
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DOI：
10.1086/589241
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发表时间：
2008-07-15
影响因子：
11.8
通讯作者：
Huang, Susan S.
中科院分区：
文献类型：
--
作者：
Datta, Rupak;Huang, Susan S.
背景。新感染耐甲氧西林金黄色葡萄球菌 (MRSA) 的患者因这种病原体而具有显着的短期发病和死亡风险。我们感兴趣的是评估长期携带者是否具有持续的疾病风险，以及是否所有携带者，无论携带时间长短，都应被视为采取干预措施以降低感染风险的合理候选者。方法。我们进行了一项单中心回顾性队列研究，以评估已知携带 MRSA 至少 1 年的患者（即流行携带者）随后发生 MRSA 感染和死亡的风险。结果。在 281 名流行携带者中，65 名（23%）在被确定为流行携带者后的一年内总共发生了 96 种离散且不相关的 MRSA 感染。最常见的感染是肺炎（占 MRSA 感染的 39%）、软组织感染（14%）和中心静脉导管感染（14%）。百分之二十四的感染涉及菌血症。新住院期间发生 38 例 MRSA 感染，其中 32 例 (84%) 是因入院原因而入院。 MRSA 导致 14 人死亡，其中 6 人被认为是由 MRSA 造成的。藏有 MRSA！ 2 年以及在检测为流行携带者时 MRSA 定植可预测随后感染 MRSA。结论。已知携带 MRSA 长达 11 年的个人随后出现 MRSA 发病和死亡的风险很高，除了新感染这种病原体的个人外，还应将其视为干预目标。
Background. Patients with newly acquired methicillin-resistant Staphylococcus aureus (MRSA) have significant risks of short-term morbidity and mortality due to this pathogen. We were interested in assessing whether long-term carriers have persistent risks of disease and whether all carriers, regardless of the duration of carriage, should be considered to be reasonable candidates for interventions to reduce the risk of infection.Methods. We conducted a single-center retrospective cohort study to evaluate the risk of subsequent MRSA infection and death among patients known to have harbored MRSA for at least 1 year (i.e., prevalent carriers).Results. Among 281 prevalent carriers, 65 (23%) developed a total of 96 discrete and unrelated MRSA infections in the year after their identification as prevalent carriers. The most common infections were pneumonia (accounting for 39% of MRSA infections), soft-tissue infection (14%), and central venous catheter infection (14%). Twenty-four percent of all infections involved bacteremia. Thirty-eight MRSA infections occurred during a new hospitalization, and 32 (84%) of these infections were the reason for admission to the hospital. MRSA contributed to 14 deaths, with 6 of these deaths deemed to be attributable to MRSA. Harboring MRSA for ! 2 years and MRSA colonization at the time of detection as a prevalent carrier were predictive of subsequent infection with MRSA.Conclusions. Individuals who are known to have harbored MRSA for 11 year are at high risk for subsequent MRSA morbidity and mortality and should be considered to be targets for intervention, in addition to individuals who have newly acquired this pathogen.