Methicillin-resistant Staphylococcus aureus nasal colonization and infection in an intensive care unit of a university hospital in China.
Methicillin-resistant Staphylococcus aureus nasal colonization and infection in an intensive care unit of a university hospital in China.
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DOI：
10.1177/0300060518777812
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发表时间：
2018-09
期刊：
影响因子：
--
通讯作者：
Yin W
中科院分区：
文献类型：
--
作者：
Qiao F;Huang W;Cai L;Zong Z;Yin W
本研究旨在确定中国大陆重症监护病房（ICU）入院时和ICU住院期间鼻内耐甲氧西林金黄色葡萄球菌（MRSA）定植的患病率和风险因素。一项前瞻性观察性研究于2011年至2013年在中国一家拥有4300张床位的教学医院的50张床位的普通ICU中进行。对于在ICU停留超过3天的患者，在ICU入院时和出院时获得用于MRSA检测的鼻拭子。总共有115名患者（4.1%; 95%置信区间[CI]，3.4-4.9）在ICU入院时已经定植了MRSA，另外185名患者（10.7%; 95% CI，9.3-12.2）在ICU住院期间获得了MRSA。ICU入院时MRSA定植患者发生MRSA感染的可能性显著高于无MRSA定植患者（比值比[OR]，2.8; 95%CI，1.1-7.3）。与MRSA检测阴性的患者相比，感染MRSA的患者在ICU的住院时间明显延长（23.3天），住院费用也更高（135，171元人民币;约19，590美元）。中国大陆ICU患者MRSA定植率较高。MRSA阳性鼻拭子的患者更有可能发生MRSA感染。
This study was performed to determine the prevalence and risk factors associated with nasal methicillin-resistant Staphylococcus aureus (MRSA) colonization upon intensive care unit (ICU) admission and during the ICU stay in mainland China. A prospective observational study was performed in a 50-bed general ICU of a 4300-bed teaching hospital in China from 2011 to 2013. Nasal swabs for MRSA detection were obtained upon ICU admission and at discharge for patients having stayed in the ICU for longer than 3 days. In total, 115 patients (4.1%; 95% confidence interval [CI], 3.4–4.9) were already colonized with MRSA on ICU admission, and another 185 patients (10.7%; 95% CI, 9.3–12.2) acquired MRSA during their ICU stay. Development of an MRSA infection was significantly more likely in patients with than without MRSA colonization on ICU admission (odds ratio [OR], 2.8; 95% CI, 1.1–7.3). Patients who acquired MRSA had significantly prolonged lengths of stay in the ICU (23.3 days) and higher hospital bills (135,171 RMB; about 19,590 USD) than those who tested negative for MRSA. The MRSA colonization rate among ICU patients in mainland China is high. Patients with MRSA-positive nasal swabs are more likely to develop MRSA infections.
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