Community-associated methicillin-resistant Staphylococcus aureus transmission in households of infected cases: a pooled analysis of primary data from three studies across international settings.
Community-associated methicillin-resistant Staphylococcus aureus transmission in households of infected cases: a pooled analysis of primary data from three studies across international settings.
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DOI：
10.1017/s0950268814000983
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发表时间：
2015-01
影响因子：
4.2
通讯作者：
Lowy FD
中科院分区：
文献类型：
--
作者：
Knox J;Van Rijen M;Uhlemann AC;Miller M;Hafer C;Vavagiakis P;Shi Q;Johnson PD;Coombs G;Kluytmans-Van Den Bergh M;Kluytmans J;Bennett CM;Lowy FD
不同类型的耐甲氧西林金黄色葡萄球菌(MRSA)会在世界各地的社区环境中造成感染。为了检查家庭内传播的异质性，并确定家庭跨环境传播的共同危险因素，汇集了在美国纽约、北卡罗来纳州布赖达和澳大利亚墨尔本进行的研究的原始数据。在指示患者感染MRSA后，家庭成员填写了问卷并提供了鼻拭子。对金黄色葡萄球菌阳性的拭子进行SPA测序。使用具有稳健误差方差的泊松回归来估计临床分离株传播给非索引家庭成员的患病率优势比。在不同的研究中，菌株类型存在很大的多样性。尽管研究之间存在差异，但在家访时被临床分离株定植的指标患者(P<；.01)和家庭成员18年的百分比(P<；.01)独立地与传播有关。可以在不同的地理环境中使用有针对性的非殖民化战略，以限制家庭中MRSA的传播。
Diverse strain types of methicillin resistant Staphylococcus aureus (MRSA) cause infections in community settings worldwide. To examine heterogeneity of spread within households and to identify common risk factors for household transmission across settings, primary data from studies conducted in New York, US, Breda, NL, and Melbourne, AU were pooled. Following MRSA infection of the index patient, household members completed questionnaires and provided nasal swabs. Swabs positive for S. aureus were genotyped by spa-sequencing. Poisson regression with robust error variance was used to estimate prevalence odds ratios for transmission of the clinical isolate to non-index household members. Great diversity of strain types existed across studies. Despite differences between studies, the index patient being colonized with the clinical isolate at the home visit (p<.01) and the percent of household members <18 years (p<.01) were independently associated with transmission. Targeted decolonization strategies could be used across geographic settings to limit household MRSA transmission.