Shukla S, Nixon M, Acharya M, Korim M T, Pandey R
Department of Trauma and Orthopaedics, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK.
J Bone Joint Surg Br. 2009 Feb;91(2):225-8. doi: 10.1302/0301-620X.91B2.21715.
We examined the incidence of infection with methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to the Leicester Royal Infirmary Trauma Unit between January 2004 and June 2006. The influence of MRSA status at the time of their admission was examined, together with age, gender and diagnosis, using multi-variant analysis. Of 2473 patients, 79 (3.2%) were MRSA carriers at the time of admission and 2394 (96.8%) were MRSA-negative. Those carrying MRSA at the time of admission were more likely to develop surgical site infection with MRSA (7 of 79 patients, 8.8%) than non-MRSA carriers (54 of 2394 patients, 2.2%, p < 0.001). Further analysis showed that hip fracture and increasing age were also risk factors with a linear increase in relative risk of 1.8% per year. MRSA carriage at admission, age and the pathology are all associated with an increased rate of developing MRSA wound infection. Identification of such risk factors at admission helps to target health-care resources, such the use of glycopeptide antibiotics at induction and the 'building-in' of increased vigilance for wound infection pre-operatively.
我们调查了2004年1月至2006年6月期间入住莱斯特皇家医院创伤科的患者中耐甲氧西林金黄色葡萄球菌（MRSA）感染的发生率。采用多变量分析方法，研究了患者入院时MRSA状态的影响，同时考虑了年龄、性别和诊断情况。在2473例患者中，79例（3.2%）入院时为MRSA携带者，2394例（96.8%）为MRSA阴性。入院时携带MRSA的患者比非MRSA携带者更易发生MRSA手术部位感染（79例患者中有7例，8.8%，而2394例患者中有54例，2.2%，p<0.001）。进一步分析表明，髋部骨折和年龄增长也是危险因素，相对风险每年呈1.8%的线性增加。入院时携带MRSA、年龄和病理情况均与发生MRSA伤口感染的几率增加有关。在入院时识别这些危险因素有助于合理分配医疗资源，如在诱导期使用糖肽类抗生素以及在术前提高对伤口感染的警惕性。
