RISK-FACTORS FOR NOSOCOMIAL BACTEREMIA DUE TO METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS
RISK-FACTORS FOR NOSOCOMIAL BACTEREMIA DUE TO METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS
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DOI：
10.1007/bf02026134
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发表时间：
1994-01-01
影响因子：
4.5
通讯作者：
GUDIOL, F
中科院分区：
文献类型：
--
作者：
PUJOL, M;PENA, C;GUDIOL, F
一项前瞻性监测研究（1990年2月至1991年12月）在一所拥有1000个床位的教学医院进行，旨在确定院内耐甲氧西林金黄色葡萄球菌（MRSA）菌血症的危险因素，发现309例患者被MRSA定植（n = 103, 33%）或感染（n = 206, 67%）。其中63人出现菌血症。与同期发生甲氧西林敏感金黄色葡萄球菌引起的院内菌血症的114例患者相比，MRSA菌血症患者有更严重的基础疾病（p < 0.01），入住重症监护病房的频率更高（p < 0.01），既往接受抗生素治疗的频率更高（p < 0.01）。为了进一步确定MRSA菌血症的危险因素，我们以MRSA菌血症的发生率为因变量，对这309例患者进行单因素和多因素分析。在分析的14个变量中，血管内置管（定义为一个或多个血管内置管放置超过48小时）是逻辑回归模型选择的唯一变量，作为独立危险因素（or = 2.7, CI = 1.1-6.6）。本研究的结果加强了最近的抗生素治疗可能使患者易患MRSA感染的概念，并提示在MRSA定植或感染的患者中，血管内导管患者发生MRSA菌血症的风险较高。
In a prospective surveillance study (February 1990-December 1991) performed at a 1000-bed teaching hospital to identify risk factors for nosocomial methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, 309 patients were found to be colonized (n = 103; 33 %) or infected (n = 206; 67 %) by MRSA. Sixty-three of them developed bacteremia. Compared with 114 patients who had nosocomial bacteremia caused by methicillin-sensitive Staphylococcus aureus during the same period of time, MRSA bacteremic patients had more severe underlying diseases (p < 0.01), were more often in intensive care units (p < 0.01) and had received prior antibiotic therapy more frequently (p < 0.01). To further identify risk factors for MRSA bacteremia, univariate and multivariate analyses of this series of 309 patients were performed using the occurrence of MRSA bacteremia as the dependent variable. Among 14 variables analyzed, intravascular catheterization, defined as one or more intravascular catheters in place for more than 48 h, was the only variable selected by a logistic regression model as an independent risk factor (OR = 2.7, CI = 1.1-6.6). The results of this study reinforce the concept that recent antibiotic therapy may predispose patients to MRSA infection and suggest that among patients colonized or infected by MRSA, those with intravascular catheters are at high risk of developing MRSA bacteremia.