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急诊科人员金黄色葡萄球菌鼻腔定植的患病率

Prevalence of Staphylococcus aureus nasal colonization in emergency department personnel.

作者信息

Suffoletto Brian P, Cannon Eliot H, Ilkhanipour Kaveh, Yealy Donald M

机构信息

University of Pittsburgh Department of Emergency Medicine, Pittsburgh, PA, USA.

出版信息

Ann Emerg Med. 2008 Nov;52(5):529-33. doi: 10.1016/j.annemergmed.2008.03.020. Epub 2008 Apr 24.

Abstract

STUDY OBJECTIVE

Nasal colonization with Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) can precede infection in patients and contacts. Although general population S aureus/MRSA rates are well described, the prevalence of S aureus and MRSA nasal colonization in emergency department health care workers is not defined. We seek to determine the prevalence of S aureus and MRSA nasal colonization among ED health care workers without evidence of an active site of staphylococcal infection and identify variables associated with colonization.

METHODS

We prospectively studied a convenience sample of ED health care workers from 5 urban teaching hospitals in Pittsburgh, PA. Each participant completed a questionnaire and nasal culturing. We tested susceptibility with the oxacillin disc diffusion method. We analyzed data with descriptive statistics and univariate regression, with alpha set at 0.05.

RESULTS

Of 255 subjects, 23% were physicians; 62% were nurses, nursing assistants, or patient care technicians; and 15% were clerical staff or social service workers. Of 81 (31.8%) S aureus isolates, 11 (13.6%) were MRSA, an overall prevalence of 4.3%. All positive MRSA samples were from nurses, nursing assistants, or patient care technicians. No other covariate had an association with S aureus or MRSA colonization.

CONCLUSION

In this urban ED health care worker population, the prevalence of S aureus is similar but MRSA nasal colonization is higher than previously reported estimates in the general population of the United States. Physicians and nonpatient contact ED health care workers did not have MRSA colonization.

摘要

研究目的

金黄色葡萄球菌和耐甲氧西林金黄色葡萄球菌(MRSA)在患者及其接触者中定殖于鼻腔后可能引发感染。尽管普通人群中金黄色葡萄球菌/MRSA的感染率已有详尽描述,但急诊科医护人员中金黄色葡萄球菌和MRSA鼻腔定殖的患病率尚无定论。我们旨在确定无葡萄球菌感染活跃部位证据的急诊科医护人员中金黄色葡萄球菌和MRSA鼻腔定殖的患病率,并识别与定殖相关的变量。

方法

我们对宾夕法尼亚州匹兹堡市5家城市教学医院的急诊科医护人员进行了一项前瞻性便利抽样研究。每位参与者都完成了一份问卷并进行了鼻腔培养。我们采用苯唑西林纸片扩散法检测药敏性。我们使用描述性统计和单变量回归分析数据,设定α为0.05。

结果

在255名受试者中,23%为医生;62%为护士、护理助理或患者护理技术员;15%为文职人员或社会服务工作者。在81株(31.8%)金黄色葡萄球菌分离株中,11株(13.6%)为MRSA,总体患病率为4.3%。所有阳性MRSA样本均来自护士、护理助理或患者护理技术员。没有其他协变量与金黄色葡萄球菌或MRSA定殖相关。

结论

在这个城市急诊科医护人员群体中,金黄色葡萄球菌的患病率与美国普通人群相似,但MRSA鼻腔定殖率高于此前报道的估计值。医生和非患者接触的急诊科医护人员没有MRSA定殖。

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