Community-associated methicillin-resistant Staphylococcus aureus strains in pediatric intensive care unit.
Community-associated methicillin-resistant Staphylococcus aureus strains in pediatric intensive care unit.
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DOI：
10.3201/eid1604.090107
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发表时间：
2010-04
影响因子：
11.8
通讯作者：
Perl TM
中科院分区：
文献类型：
--
作者：
Milstone AM;Carroll KC;Ross T;Shangraw KA;Perl TM
地方性可导致耐药性和毒力增强。毒性社区相关耐甲氧西林金黄色葡萄球菌（CA-MRSA）菌株在美国迅速传播。为了描述CA-MRSA菌株在儿科重症监护病房（PICU）输入和传播的程度，我们对2007年3月1日至2008年5月31日在约翰霍普金斯医院PICU住院的儿童进行了回顾性研究。我们发现1,674例PICU患者中有72例（6%）定植了MRSA。mrsa定植的患者较年轻（中位年龄3岁vs. 5岁；p = 0.02）和非裔美国人（p<0.001），并且在12个月内住院（p<0.001）的可能性大于未定植的患者。对66例（92%）定植患者的MRSA分离株进行指纹采集；40例（61%）为基因典型CA-MRSA菌株。CA-MRSA菌株从50%的MRSA定植患者中分离出来，并引起该队列中唯一的医院获得性MRSA导管相关血流感染。流行CA-MRSA菌株正在成为picu的地方病，可传播给住院儿童，并可引起侵袭性医院获得性感染。需要进一步评估MRSA的控制情况。
Endemicity may lead to increased resistance and virulence. Virulent community-associated methicillin-resistant Staphylococcus-aureus (CA-MRSA) strains have spread rapidly in the United States. To characterize the degree to which CA-MRSA strains are imported into and transmitted in pediatric intensive care units (PICU), we performed a retrospective study of children admitted to The Johns Hopkins Hospital PICU, March 1, 2007–May 31, 2008. We found that 72 (6%) of 1,674 PICU patients were colonized with MRSA. MRSA-colonized patients were more likely to be younger (median age 3 years vs. 5 years; p = 0.02) and African American (p<0.001) and to have been hospitalized within 12 months (p<0.001) than were noncolonized patients. MRSA isolates from 66 (92%) colonized patients were fingerprinted; 40 (61%) were genotypically CA-MRSA strains. CA-MRSA strains were isolated from 50% of patients who became colonized with MRSA and caused the only hospital-acquired MRSA catheter-associated bloodstream infection in the cohort. Epidemic CA-MRSA strains are becoming endemic to PICUs, can be transmitted to hospitalized children, and can cause invasive hospital-acquired infections. Further appraisal of MRSA control is needed.
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