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一家私立皮肤科诊所中社区获得性耐甲氧西林金黄色葡萄球菌的患病率。

Prevalence of community-acquired methicillin-resistant Staphylococcus aureus in a private dermatology office.

作者信息

Bruce Aaron M, Spencer James M

机构信息

Department of Dermatology, Sun Coast Hospital, NOVA Southeastern University, Largo, FL 33778, USA.

出版信息

J Drugs Dermatol. 2008 Aug;7(8):751-5.

Abstract

BACKGROUND

The prevalence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft tissue infection (SSTI) in private practice dermatology office is largely unknown and the prescribing of antibiotic treatment could be influenced by such data.

OBJECTIVE

Investigators sought to examine the period prevalence of CA-MRSA infections involving skin and soft tissue in a suburban private practice dermatology setting.

METHODS

Chart reviews of 170 patients who had bacterial cultures taken from January 2007 to November 2007 were performed, with an analysis of sex, age, immune status, species of growth, type of lesion, and culture site.

RESULTS

The mean age of the study population was 54.0 years (SD 21.8) and 51.1 % were male. Of the 170 cultures taken, 135 (79%) grew 1 or more bacteria and MRSA positive cultures were found in 28 (21%) of 135 cultures.

LIMITATIONS

Only 1 geographic location was represented.

CONCLUSION

The rising rates of CA-MRSA skin and soft tissue infections should be evaluated with consideration of the unique populations that the majority of reports represent. There is little doubt that the prevalence of skin infections caused by CA-MRSA have increased dramatically and will likely continue to do so in the future. However, the authors caution the empiric prescribing of antibiotics presently known to be effective against CA-MRSA and advocate the culturing of all infectious lesions upon presentation and reserve these antibiotics (tetracyclines, trimethoprim-sulfamethoxazole [TMP-SMX], clindamycin, rifampin) for the treatment of high-risk patients and patients with culture proven CA-MRSA infections.

摘要

背景

在私人执业皮肤科诊所中,社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)皮肤及软组织感染(SSTI)的患病率很大程度上未知,而此类数据可能会影响抗生素治疗的处方。

目的

研究者试图调查在郊区私人执业皮肤科环境中涉及皮肤和软组织的CA-MRSA感染的期间患病率。

方法

对2007年1月至2007年11月期间进行细菌培养的170例患者的病历进行回顾,分析性别、年龄、免疫状态、生长菌种、病变类型和培养部位。

结果

研究人群的平均年龄为54.0岁(标准差21.8),男性占51.1%。在采集的170份培养物中,135份(79%)培养出1种或更多细菌,在135份培养物中有28份(21%)的MRSA培养结果呈阳性。

局限性

仅代表1个地理位置。

结论

应结合大多数报告所代表的独特人群来评估CA-MRSA皮肤和软组织感染率的上升情况。毫无疑问,由CA-MRSA引起的皮肤感染患病率已大幅上升,且未来可能会继续上升。然而,作者告诫不要凭经验使用目前已知对CA-MRSA有效的抗生素,并主张对所有出现的感染性病变进行培养,将这些抗生素(四环素、复方新诺明、克林霉素、利福平)留作治疗高危患者以及培养证实为CA-MRSA感染的患者。

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