Safdar Nasia, Bradley Elisa A
Section of Infectious Diseases, Department of Medicine, University of Wisconsin Medical School, Madison, WI 53792, USA.
Am J Med. 2008 Apr;121(4):310-5. doi: 10.1016/j.amjmed.2007.07.034.
Nasal, axillary, or inguinal colonization with Staphylococcus aureus generally precedes invasive infection. Some studies have found that colonization with methicillin-resistant S. aureus (MRSA) poses a greater risk of clinical infection than colonization with methicillin-susceptible S. aureus (MSSA). However, the magnitude of risk is unclear.
We undertook a systematic review to provide an overall estimate of the risk of infection following colonization with MRSA compared with colonization by MSSA. Ten observational studies, with a total of 1170 patients, were identified that provided data on both MSSA and MRSA colonization and infection. A random-effects model was used to obtain pooled estimates of the odds ratio and 95% confidence interval.
Overall, colonization by MRSA was associated with a 4-fold increase in the risk of infection (odds ratio 4.08, 95% confidence interval, 2.10-7.44). Studies differed in the choice of patient population, severity of illness, and frequency of sampling to detect colonization.
Further research is needed to identify effective methods for sustained eradication of MRSA carriage to reduce the high risk of subsequent infection.
金黄色葡萄球菌在鼻腔、腋窝或腹股沟的定植通常先于侵袭性感染。一些研究发现，耐甲氧西林金黄色葡萄球菌（MRSA）定植比甲氧西林敏感金黄色葡萄球菌（MSSA）定植带来的临床感染风险更大。然而，风险程度尚不清楚。
我们进行了一项系统评价，以全面评估与MSSA定植相比，MRSA定植后发生感染的风险。共纳入10项观察性研究，涉及1170例患者，这些研究提供了有关MSSA和MRSA定植及感染的数据。采用随机效应模型获得比值比及95%置信区间的合并估计值。
总体而言，MRSA定植使感染风险增加4倍（比值比4.08，95%置信区间2.10 - 7.44）。各项研究在患者人群的选择、疾病严重程度以及检测定植的采样频率方面存在差异。
需要进一步研究以确定持续根除MRSA携带的有效方法，从而降低后续感染的高风险。
