Sannes Mark R, Belongia Edward A, Kieke Burney, Smith Kirk, Kieke Amy, Vandermause Mary, Bender Jeff, Clabots Connie, Winokur Patricia, Johnson James R
Infectious Diseases Section, Veterans Affairs Medical Center, Minneapolis, MN 55417, USA.
J Infect Dis. 2008 Feb 1;197(3):430-4. doi: 10.1086/525530.
To determine whether poultry contact/consumption predicts colonization with antimicrobial-resistant Escherichia coli, 567 newly hospitalized patients and 100 vegetarians were assessed microbiologically and epidemiologically. Multivariable analysis showed that poultry contact/consumption, other dietary habits, and antimicrobial use did not significantly predict resistance. In contrast, foreign travel significantly predicted both trimethoprim-sulfamethoxazole resistance (prevalence ratio, 2.7 [95% confidence interval, 1.3-5.6]) and "any resistance" (total population), whereas intensive-care-unit exposure predicted any resistance (hospital patients). Thus, most of the individual-level exposures-including poultry contact/consumption-that had been expected to be significant risk factors for infection with antimicrobial-resistant E. coli did not prove to be such. Other exposures, including household-, community-, and population-level effects, may be more important.
为了确定接触/食用家禽是否会增加耐抗菌药物大肠杆菌定植的风险,我们对567名新入院患者和100名素食者进行了微生物学和流行病学评估。多变量分析显示,接触/食用家禽、其他饮食习惯以及抗菌药物的使用并不能显著预测耐药性。相比之下,出国旅行是预测甲氧苄啶-磺胺甲恶唑耐药性(患病率比,2.7 [95%置信区间,1.3 - 5.6])和“任何耐药性”(总体人群)的显著因素,而入住重症监护病房是预测“任何耐药性”(住院患者)的显著因素。因此,大多数个体层面的暴露因素,包括接触/食用家禽,原本被认为是感染耐抗菌药物大肠杆菌的重要风险因素,但事实并非如此。其他暴露因素,包括家庭、社区和人群层面的影响,可能更为重要。