Wheller Levin, Rooney Cleone, Griffiths Clare
Office for National Statistics.
Health Stat Q. 2009 Spring(41):13-20.
This study examined factors affecting whether or not meticillin resistant Staphylococcus aureus(MRSA) is recorded on the death certificate of individuals who died following a laboratory confirmed MRSA bacteraemia and compared this with another organism, Streptococcus pneumoniae. The study included all patients with a positive MRSA or S. pneumoniae bacteraemia reported to the Health Protection Agency between 1 January 2004 and 31 December 2005 and linked to a death registered up to 31 March 2006. It was an opportunistic analysis of infection surveillance records and death registrations that had been linked for other purposes Certifiers are most likely to record MRSA on the death certificate if they believe that a large number of conditions contributed to the patient's death, and if the patient dies between 2 and 15 days following a positive blood culture. Certifiers do not appear to be deliberately omitting MRSA from death certificates; rather they report the clinical manifestation of infection or disease the patient died from, not the microbiological diagnosis. Certifiers were significantly less likely to mention S. pneumoniae than MRSA.
本研究调查了影响耐甲氧西林金黄色葡萄球菌（MRSA）是否会被记录在实验室确诊为MRSA菌血症后死亡的个体死亡证明上的因素，并将其与另一种病原体肺炎链球菌进行比较。该研究纳入了2004年1月1日至2005年12月31日期间向健康保护局报告的所有MRSA或肺炎链球菌菌血症呈阳性的患者，这些患者的死亡登记时间截至2006年3月31日。这是一项对出于其他目的而关联的感染监测记录和死亡登记进行的机会性分析。如果证明人认为有大量病症导致患者死亡，且患者在血培养呈阳性后的2至15天内死亡，那么他们最有可能在死亡证明上记录MRSA。证明人似乎并非故意在死亡证明上遗漏MRSA；相反，他们报告的是患者死亡所患感染或疾病的临床表现，而非微生物学诊断。与MRSA相比，证明人提及肺炎链球菌的可能性显著更低。
