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[慢性伤口中耐甲氧西林金黄色葡萄球菌和甲氧西林敏感金黄色葡萄球菌相关发病率:一项前瞻性研究]

[Methicilline-sensitive and methicilline-resistant Staphylococcus aureus related morbidity in chronic wounds: a prospective study].

作者信息

Trividic-Rumeau M, Bouyssou-Gauthier M-L, Mounier M, Sparsa A, Blaise S, Bédane C, Bonnetblanc J-M

机构信息

Service de Dermatologie, CHRU Dupuytren, 2, avenue Martin Luther King, 87042 Limoges Cedex.

出版信息

Ann Dermatol Venereol. 2003 Jun-Jul;130(6-7):601-5.

Abstract

OBJECTIVE

Staphylococcus aureus is the most common bacteria responsible for cutaneous infections. Its capacity to adapt has led to the selection of methicilline-resistant strains (MRSA). These strains create specific problems in their management in dermatology (mode of contamination, treatment, added costs, increased nosocomial risks). The objective of our study was to search for morbidity of MRSA in chronic cutaneous wounds in hospital settings and assess the need of systemic antibiotic therapy.

PATIENTS AND METHODS

We have conducted a one-year prospective study. All the patients hospitalized in the department with leg ulcers or foot wounds were included. Following local sampling for bacteriological examination, three groups were constituted: methicilline-sensitive patients with staphylococcus aureus (MSSA), methicilline-resistant staphylococcus aureus patients and patients in whom these bacteria were absent. Only the first two groups were compared after studying the past history, clinical description of the wound at the start of the study, results of the infectious bacteriology and of the clinical and bacteriological evolution of the wounds.

RESULTS

The two groups studied were similar in number, past history, clinical aspect and therapeutic management. Only malnutrition was more frequent in patients exhibiting MRSA. There was no difference with the evolution of the wounds.

CONCLUSION

Our study did not reveal any difference in the morbidity of staphylococcus aureus in the cutaneous wounds whether methicilline sensitive or resistant. Systematic antibiotherapy is not justified in the absence of signs of infection.

摘要

目的

金黄色葡萄球菌是引起皮肤感染最常见的细菌。其适应能力导致了耐甲氧西林菌株(MRSA)的出现。这些菌株在皮肤科的管理中产生了特定问题(污染方式、治疗、成本增加、医院感染风险增加)。我们研究的目的是探寻医院环境中慢性皮肤伤口中MRSA的发病率,并评估全身抗生素治疗的必要性。

患者与方法

我们进行了为期一年的前瞻性研究。纳入了该科室所有因腿部溃疡或足部伤口住院的患者。在进行局部采样进行细菌学检查后,分为三组:对甲氧西林敏感的金黄色葡萄球菌患者(MSSA)、耐甲氧西林金黄色葡萄球菌患者和未检出这些细菌的患者。在研究既往病史、研究开始时伤口的临床描述、感染细菌学结果以及伤口的临床和细菌学演变后,仅对前两组进行比较。

结果

所研究的两组在数量、既往病史、临床情况和治疗管理方面相似。仅在出现MRSA的患者中营养不良更为常见。伤口的演变没有差异。

结论

我们的研究未发现金黄色葡萄球菌在皮肤伤口中的发病率在甲氧西林敏感或耐药方面有任何差异。在没有感染迹象的情况下,系统性抗生素治疗不合理。

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