Importance of bacterial burden among methicillin-resistant Staphylococcus aureus carriers in a long-term care facility
Importance of bacterial burden among methicillin-resistant Staphylococcus aureus carriers in a long-term care facility
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DOI：
10.1086/526437
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发表时间：
2008-02-01
影响因子：
4.5
通讯作者：
Richards, Chesley L., Jr.
中科院分区：
文献类型：
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作者：
Stone, Nimalie D.;Lewis, Donna R.;Richards, Chesley L., Jr.
objective.评估长期护理机构（LTCF）居民中耐甲氧西林金黄色葡萄球菌（MRSA）鼻腔定植的患病率和传播情况，以及与MRSA携带相关的风险因素。设计前瞻性、纵向队列研究。设置. 100张床位的退伍军人管理局LTCF。参与者在为期8周的研究期间，LTCF的所有当前和新入院的居民。方法.每周采集鼻拭子样本，并在MRSA选择性培养基上培养，以半定量量表对培养物的生长进行分级，从0（无生长）至6（重度生长）。收集研究前和研究期间的流行病学数据，以评估MRSA携带的风险因素。结果在83名LTCF居民中，49名（59%）有1个或多个鼻腔拭子培养MRSA阳性; 34名（41%）始终培养阴性（指定为“非携带者”）。在49名培养阳性的居民中，30名（占83名居民的36%）的所有培养物均为MRSA阳性（指定为“持续携带者”），19名（占83名居民的23%）至少有1种培养物，但不是所有培养物均为MRSA阳性（指定为“间歇性携带者”）。多变量分析显示，至少有一个MRSA鼻拭子培养阳性的参与者可能有既往住院史（比值比，3.9）或伤口（比值比，8.2）。持续性携带者和间歇性携带者在流行病学特征上没有差异，但在平均MRSA生长评分上有差异（3.7 vs 0.7; P
objective. To evaluate the prevalence and transmission of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization, as well as risk factors associated with MRSA carriage, among residents of a long-term care facility (LTCF). design. Prospective, longitudinal cohort study. setting. A 100-bed Veterans Administration LTCF. participants. All current and newly admitted residents of the LTCF during an 8-week study period. methods. Nasal swab samples were obtained weekly and cultured on MRSA-selective media, and the cultures were graded for growth on a semiquantitative scale from 0 (no growth) to 6 (heavy growth). Epidemiologic data for the periods before and during the study were collected to assess risk factors for MRSA carriage. results. Of 83 LTCF residents, 49 (59%) had 1 or more nasal swab cultures that were positive for MRSA; 34 (41%) were consistently culture-negative ( designated "noncarriers"). Of the 49 culture-positive residents, 30 (36% of the total of 83 residents) had all cultures positive for MRSA (designated "persistent carriers"), and 19 (23% of the 83 residents) had at least 1 culture, but not all cultures, positive for MRSA (designated "intermittent carriers"). Multivariate analysis showed that participants with at least 1 nasal swab culture positive for MRSA were likely to have had previous hospitalization (odds ratio, 3.9) or wounds (odds ratio, 8.2). Persistent carriers and intermittent carriers did not differ in epidemiologic characteristics but did differ in mean MRSA growth score (3.7 vs 0.7; P