Skin infection in children colonized with community-associated methicillin-resistant Staphylococcus aureus
Skin infection in children colonized with community-associated methicillin-resistant Staphylococcus aureus
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DOI：
10.1016/j.jinf.2009.09.001
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发表时间：
2009-12-01
影响因子：
28.2
通讯作者：
Storch, Gregory A.
中科院分区：
文献类型：
--
作者：
Fritz, Stephanie A.;Epplin, Emma K.;Storch, Gregory A.
目的：社区相关耐甲氧西林金黄色葡萄球菌(CA-MRSA)鼻腔定植与儿童继发感染的关系尚不清楚。我们试图确定社区儿童皮肤和软组织感染(SSTI)的危险因素。方法：先前的一项研究测量了1300名社区儿童金黄色葡萄球菌鼻部定植的患病率。结果：在最初的6个月期间，56/708(8.1%)的被调查者报告了SSTI。SSTI发生于6/26(23%)初始定植耐甲氧西林金黄色葡萄球菌，16/194(8%)甲氧西林敏感金黄色葡萄球菌定植，34/474(7%)未定植金黄色葡萄球菌(单因素分析，MRSA与非MRSA，p=0.014)。多因素分析显示，儿童出生前一年内有过性病史(p<；0.01)和家庭接触者中有过性病史(p<；0.01)，鼻腔内MRSA定植接近统计学意义(p=0.08)。结论：在当前社区MRSA传播时代，SSTI是一种家庭疾病，指标病例和家庭接触者中均有复发。患有耐甲氧西林金黄色葡萄球菌定植的儿童可能面临随后的SSTI的风险。应高度重视对耐甲氧西林金黄色葡萄球菌在家庭中的传播动态和预防策略的进一步研究。(C)2009年英国感染学会。爱思唯尔有限公司出版。保留所有权利。
Objectives: The relationship between community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) nasal colonization and subsequent infection in children is unknown. We sought to define risk factors for skin and soft tissue infection (SSTI) in community children.Methods: A prior study measured S. aureus nasal colonization prevalence for 1300 community children. To detect subsequent SSTI in these children or a household member, surveys were administered 6 and 12 months following enrollment.Results: SSTIs were reported by 56/708 (8.1%) respondents during the initial 6-month interval. SSTI developed in 6/26 (23%) initially colonized with MRSA, 16/194 (8%) with methicillin-sensitive S. aureus colonization, and 34/474 (7%) not colonized with S. aureus (MRSA vs. not MRSA, univariate analysis, p = 0.014). In multivariable analysis, factors associated with SSTI included history of SSTI in the child during the year preceding enrollment (p < 0.01) and SSTI in household contacts during the follow-up interval (p < 0.01); MRSA nasal colonization approached statistical significance (p = 0.08).Conclusions: In the current era of community MRSA transmission, SSTI is a disease of households, with recurrences in index cases and occurrences among household contacts. Children with MRSA colonization may be at risk for subsequent SSTI. Further study of MRSA transmission dynamics in households and preventive strategies should receive high priority. (C) 2009 The British Infection Society. Published by Elsevier Ltd. All rights reserved.