The risk of infection after nasal colonization with Staphylococcus aureus
The risk of infection after nasal colonization with Staphylococcus aureus
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DOI：
10.1016/j.amjmed.2007.07.034
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发表时间：
2008-04-01
影响因子：
5.9
通讯作者：
Bradley, Elisa A.
中科院分区：
文献类型：
--
作者：
Safdar, Nasia;Bradley, Elisa A.
目的：金黄色葡萄球菌的鼻腔、腋窝或腹股沟定植通常先于侵袭性感染。一些研究发现，耐甲氧西林金黄色葡萄球菌（MRSA）定殖比甲氧西林敏感金黄色葡萄球菌（MSSA）定殖具有更大的临床感染风险。然而，风险的大小尚不清楚。方法：我们进行了一项系统综述，以提供MRSA定殖后感染风险的总体估计，并与MSSA定殖进行比较。10项观察性研究，共1170例患者，确定了MSSA和MRSA定植和感染的数据。随机效应模型用于获得优势比和95%置信区间的合并估计。结果：总体而言，MRSA定植与感染风险增加4倍相关（优势比4.08,95%可信区间2.10-7.44）。研究在患者群体的选择、疾病的严重程度和检测定植的采样频率方面存在差异。结论：需要进一步研究确定持续根除MRSA携带的有效方法，以降低后续感染的高风险。(C) 2008爱思唯尔公司版权所有。
PURPOSE: Nasal, axillary, or inguinal colonization with Staphylococcus aureus generally precedes invasive infection. Some studies have found that colonization with methicillin-resistant S. aureus (MRSA) poses a greater risk of clinical infection than colonization with methicillin-susceptible S. aureus (MSSA). However, the magnitude of risk is unclear.METHODS: We undertook a systematic review to provide an overall estimate of the risk of infection following colonization with MRSA compared with colonization by MSSA. Ten observational studies, with a total of 1170 patients, were identified that provided data on both MSSA and MRSA colonization and infection. A random-effects model was used to obtain pooled estimates of the odds ratio and 95% confidence interval.RESULTS: Overall, colonization by MRSA was associated with a 4-fold increase in the risk of infection (odds ratio 4.08, 95% confidence interval, 2.10-7.44). Studies differed in the choice of patient population, severity of illness, and frequency of sampling to detect colonization.CONCLUSION: Further research is needed to identify effective methods for sustained eradication of MRSA carriage to reduce the high risk of subsequent infection. (C) 2008 Elsevier Inc. All rights reserved.