Lepelletier D, Ferréol S, Villers D, Richet H
Laboratoire de bactériologie-virologie, hygiène hospitalière, hôpital Laënnec, boulevard Jean-Monod, CHU de Nantes, 44100 Nantes cedex 01, France.
Pathol Biol (Paris). 2004 Oct;52(8):474-9. doi: 10.1016/j.patbio.2004.06.002.
Methicillin resistance and infections caused by methicillin-resistant Staphylococcus aureus represent a growing problem and a challenge for health-care institutions. We evaluated risk factors, morbidity and cost of infections caused by methicillin-resistant (MRSA) and methicillin-susceptible (MSSA) Staphylococcus aureus.
We performed an un-matched case-control study in an 20-bed medical intensive care unit from 1994-2001 at Nantes teaching hospital, France. All patients with pneumonia, bacteraemia and urinary MRSA (cases) or MSSA (controls) nosocomial infections were included in the study.
Twenty four patients with MRSA infection were compared to 64 patients with MSSA infections. Patients with MRSA infection were older (56 vs. 45 years, P < 0.01), had longer length of stay (47 vs. 35 days, P < 0.05) and were infected later (22 vs. 10 days, P < 0.00001) than patients with MSSA infection. No difference was observed between the two groups according to the Omega index, acute simplify index and mortality. MRSA infections involved extra cost due to antimicrobial treatment (184 vs. 72 Euros, P < 0.005) and length of stay (37,278 vs. 27,755 Euros, P < 0.05).
Patient infected by MRSA seems to be different from patient infected by MSSA but without consequence on Omega index and mortality. But methicillin-resistance involves extra cost due to antimicrobial treatment and length of stay.
耐甲氧西林及耐甲氧西林金黄色葡萄球菌引起的感染对医疗机构来说是一个日益严重的问题和挑战。我们评估了耐甲氧西林（MRSA）和甲氧西林敏感（MSSA）金黄色葡萄球菌引起感染的危险因素、发病率及成本。
我们于1994年至2001年在法国南特教学医院的一个拥有20张床位的医疗重症监护病房进行了一项非匹配病例对照研究。所有患有肺炎、菌血症和泌尿系统MRSA（病例）或MSSA（对照）医院感染的患者均纳入研究。
将24例MRSA感染患者与64例MSSA感染患者进行比较。MRSA感染患者年龄更大（56岁对45岁，P<0.01），住院时间更长（47天对35天，P<0.05），且比MSSA感染患者感染时间更晚（22天对10天，P<0.00001）。根据欧米伽指数、急性简化指数和死亡率，两组之间未观察到差异。MRSA感染因抗菌治疗（184欧元对72欧元，P<0.005）和住院时间（37278欧元对27755欧元，P<0.05）而产生额外费用。
感染MRSA的患者似乎与感染MSSA的患者不同，但对欧米伽指数和死亡率没有影响。但耐甲氧西林因抗菌治疗和住院时间而涉及额外费用。
