Weber Stephen G, Gold Howard S, Hooper David C, Karchmer A W, Carmeli Yehuda
Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
Emerg Infect Dis. 2003 Nov;9(11):1415-22. doi: 10.3201/eid0911.030284.
To determine whether fluoroquinolone exposure is a risk factor for the isolation of Staphylococcus aureus and whether the effect is different for methicillin-resistant S. aureus (MRSA) versus methicillin--susceptible S. aureus (MSSA), we studied two case groups. The first case group included 222 patients with nosocomially acquired MRSA. The second case group included 163 patients with nosocomially acquired MSSA. A total of 343 patients admitted concurrently served as controls. Outcome measures were the adjusted odds ratio (OR) for isolation of MRSA and MSSA after fluoroquinolone exposure. Exposure to both levofloxacin (OR 5.4; p <0.0001) and ciprofloxacin (OR 2.2; p < 0.003) was associated with isolation of MRSA but not MSSA. After adjustment for multiple variables, both drugs remained risk factors for MRSA (levofloxacin OR 3.4; p <0.0001; ciprofloxacin OR 2.5; p = 0.005) but not MSSA. Exposure to levofloxacin or ciprofloxacin is a significant risk factor for the isolation of MRSA, but not MSSA.
为了确定氟喹诺酮类药物的暴露是否是金黄色葡萄球菌分离的危险因素，以及耐甲氧西林金黄色葡萄球菌（MRSA）与甲氧西林敏感金黄色葡萄球菌（MSSA）的影响是否不同，我们研究了两个病例组。第一个病例组包括222例医院获得性MRSA患者。第二个病例组包括163例医院获得性MSSA患者。共有343例同时入院的患者作为对照。观察指标是氟喹诺酮类药物暴露后MRSA和MSSA分离的校正比值比（OR）。左氧氟沙星（OR 5.4；p<0.0001）和环丙沙星（OR 2.2；p<0.003）的暴露均与MRSA的分离有关，但与MSSA无关。在对多个变量进行校正后，两种药物仍然是MRSA的危险因素（左氧氟沙星OR 3.4；p<0.0001；环丙沙星OR 2.5；p = 0.005），但不是MSSA的危险因素。左氧氟沙星或环丙沙星的暴露是MRSA分离的重要危险因素，但不是MSSA的危险因素。
