Centers for Disease Control and Prevention, Anchorage, Alaska 99508-5932, USA.
Emerg Infect Dis. 2010 May;16(5):797-803. doi: 10.3201/eid1605.091851.
Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are common in southwestern Alaska. Outbreak strains have been shown to carry the genes for Panton-Valentine leukocidin (PVL). To determine if carriage of PVL-positive CA-MRSA increased the risk for subsequent soft tissue infection, we conducted a retrospective cohort study by reviewing the medical records of 316 persons for 3.6 years after their participation in a MRSA nasal colonization survey. Demographic, nasal carriage, and antimicrobial drug use data were analyzed for association with skin infection risk. Skin infections were more likely to develop in MRSA carriers than in methicillin-susceptible S. aureus carriers or noncarriers of S. aureus during the first follow-up year, but not in subsequent years. Repeated skin infections were more common among MRSA carriers. In an area where PVL-containing MRSA is prevalent, skin infection risk was increased among MRSA nasal carriers compared with methicillin-susceptible S. aureus carriers and noncarriers, but risk differential diminished over time.
社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）感染在阿拉斯加西南部很常见。爆发菌株已被证明携带杀白细胞素（PVL）基因。为了确定携带 PVL 阳性 CA-MRSA 是否会增加随后发生软组织感染的风险，我们对 316 名参与者参与耐甲氧西林金黄色葡萄球菌鼻腔定植调查后的 3.6 年进行了回顾性队列研究。对人口统计学、鼻腔定植和抗生素使用数据进行了分析，以确定与皮肤感染风险的关联。在第一年的随访中，MRSA 携带者比甲氧西林敏感金黄色葡萄球菌携带者或金黄色葡萄球菌非携带者更容易发生皮肤感染，但在随后的几年中并非如此。MRSA 携带者更容易发生反复皮肤感染。在含有 PVL 的 MRSA 流行的地区，与甲氧西林敏感的金黄色葡萄球菌携带者和非携带者相比，MRSA 鼻腔携带者的皮肤感染风险增加，但风险差异随时间逐渐减弱。
