近日刊登在国际杂志Infection Control and Hospital Epidemiology上的一项研究报告指出,纽约市因为社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)感染所致的住院率超出1997年至2006年的三倍还多。大多数的MRSA感染都是在医院内、医疗保健过程中获得感染的,近年来公共健康专家越来越关注社区型如家庭、学校等地方的MRSA感染。
3579人已经加入了纽约市医院关于CA-MRSA的感染研究中,CA-MRSA感染率从1997年的113人到2006年的875人。医院收容治疗的20%的感染者均为社区获得型感染。
研究者的研究发现揭示了从1997年以来社区获得性MRSA感染率的上升。相比住院治疗的病人来说,研究者指出,相比一般人群,肥胖者或者感染HIV以及无家可归的人群更容易感染CA-MRSA。作者推测了增加的感染风险和人口统计数据、并存病有密切关系;在肥胖病人和HIV感染者中常常存在皮肤创伤,这就为MRSA感染提供了条件。而且男性和孩子由于经常进行户外运动,因此感染MRSA的风险也大大增加。这项研究建议,应该通过抑制社区获得性MRSA的感染从而来降低感染风险,增加公众的健康效应。卫生部应当教育那些感染CA-MRSA的无家可归者,并且及时教育人们寻找医疗求助以及防止疾病互相传染等等。(生物谷Bioon.com)
编译自:Community-Acquired MRSA Cases On the Rise in New York City, Study Suggests
编译者:T.Shen
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Trends in Hospitalization for Community-Associated Methicillin-Resistant Staphylococcus aureus in New York City, 1997-2006: Data from New York State's Statewide Planning and Research Cooperative System.
Farr AM, Aden B, Weiss D, Nash D, Marx MA.
Objective. To describe trends in hospitalizations with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection in New York City over 10 years and to explore the demographics and comorbidities of patients hospitalized with CA-MRSA infections. Design. Retrospective analysis of hospital discharges from New York State's Statewide Planning and Research Cooperative System database from 1997 to 2006. Patients. All patients greater than 1 year of age admitted to New York hospitals with diagnosis codes indicating MRSA who met the criteria for CA-MRSA on the basis of admission information and comorbidities. Methods. We determined hospitalization rates and compared demographics and comorbidities of patients hospitalized with CA-MRSA versus those hospitalized with all other non-MRSA diagnoses by multivariable logistic regression. Results. Of 18,226 hospitalizations with an MRSA diagnosis over 10 years, 3,579 (20%) were classified as community-associated. The CA-MRSA hospitalization rate increased from 1.47 to 10.65 per 100,000 people overall from 1997 to 2006. Relative to non-MRSA hospitalizations, men, children, Bronx and Manhattan residents, the homeless, patients with human immunodeficiency virus (HIV) infection, and persons with diabetes had higher adjusted odds of CA-MRSA hospitalization. Conclusions. The CA-MRSA hospitalization rate appeared to increase between 1997 and 2006 in New York City, with residents of the Bronx and Manhattan, men, and persons with HIV infection or diabetes at increased odds of hospitalization with CA-MRSA. Further studies are needed to explore how changes in MRSA incidence, access to care, and other factors may have impacted these rates.