Johnson Jennifer K, Khoie Tina, Shurland Simone, Kreisel Kristen, Stine O Colin, Roghmann Mary-Claire
Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
Emerg Infect Dis. 2007 Aug;13(8):1195-200. doi: 10.3201/eid1308.061575.
Until recently, methicillin-resistant Staphylococcus aureus (MRSA) has caused predominantly healthcare-associated infections. We studied MRSA infections and overall skin and soft tissue infections (SSTIs) in outpatients receiving care at the Baltimore Veterans Affairs Medical Center Emergency Care Service during 2001-2005. We found an increase in MRSA infections, from 0.2 to 5.9 per 1,000 visits (p < 0.01); most were community-associated SSTIs. Molecular typing showed that > 80% of MRSA infections were caused by USA300. In addition, SSTI visits increased from 20 to 61 per 1,000 visits (p < 0.01). The proportion of SSTI cultures that yielded MRSA increased from 4% to 42% (p < 0.01), while the proportion that yielded methicillin-sensitive S. aureus remained the same (10% to 13%, p = 0.5). The increase in community-associated MRSA infections and the overall increase in SSTIs in our population suggest that USA300 is becoming more virulent and has a greater propensity to cause SSTIs.
直到最近，耐甲氧西林金黄色葡萄球菌（MRSA）主要引起与医疗保健相关的感染。我们研究了2001年至2005年期间在巴尔的摩退伍军人事务医疗中心急诊服务部门接受治疗的门诊患者中的MRSA感染以及总体皮肤和软组织感染（SSTIs）情况。我们发现MRSA感染有所增加，从每1000次就诊中的0.2例增至5.9例（p < 0.01）；大多数是社区相关性SSTIs。分子分型显示，超过80%的MRSA感染由USA300引起。此外，SSTI就诊次数从每1000次就诊中的20次增至61次（p < 0.01）。培养出MRSA的SSTI比例从4%增至42%（p < 0.01），而培养出甲氧西林敏感金黄色葡萄球菌的比例保持不变（从10%至13%，p = 0.5）。我们人群中社区相关性MRSA感染的增加以及SSTIs的总体增加表明，USA300的毒力正在增强，且更易引发SSTIs。
