Academic Unit of Primary Health Care, National Institute for Health Research School for Primary Care Research, School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol BS8 2PS, UK.
Int J Antimicrob Agents. 2012 Feb;39(2):135-41. doi: 10.1016/j.ijantimicag.2011.09.022. Epub 2011 Nov 10.
The objectives of this study were to investigate the relationship between primary care antibiotics prescribed within 2 months and 12 months and the carriage of meticillin-resistant Staphylococcus aureus (MRSA) in nasal flora from a large representative sample of community-resident adults. S. aureus isolates were obtained from nasal samples submitted by UK resident adults aged ≥ 16 years registered with 12 general practices in the former Avon and Gloucestershire health authority areas. Individual-level antibiotic exposure data during the 12 months prior to providing the samples were collected from the primary care electronic records. MRSA status was determined by measuring resistance to cefoxitin. In total, 6937 adults were invited to take part, of whom 5917 returned a nasal sample. S. aureus was identified in 946 samples and a total of 761 participants consented to primary care record review and had complete data for the analyses. There was no evidence of an association between any antibiotic in the previous 2 months and MRSA isolation, with an adjusted odds ratio (aOR) of 1.33 [95% confidence interval (CI) 0.12-15; P=0.8]. There was a suggestion of an association between any antibiotic use in the previous 12 months and MRSA, with an aOR of 2.45 (95% CI 0.95-6.3; P=0.06). In conclusion, there is a suggestion that antibiotics prescribed within 12 months is associated with the carriage of MRSA, but not within 2 months, although the 2-month analysis had fewer data subjects and was therefore underpowered to detect this association. A larger study would be able to clarify these associations further.
本研究的目的是调查在 2 个月和 12 个月内开具的初级保健抗生素与社区成年居民鼻腔菌群中耐甲氧西林金黄色葡萄球菌（MRSA）携带的关系。从英国居住的年龄≥16 岁的成年人的鼻腔样本中获得金黄色葡萄球菌分离株，这些成年人在阿冯和格洛斯特郡卫生区的 12 个普通实践中注册。在提供样本前的 12 个月内，从初级保健电子记录中收集个体抗生素暴露数据。通过测量对头孢西丁的耐药性来确定 MRSA 状态。共有 6937 名成年人受邀参加，其中 5917 名返回了鼻腔样本。在 946 个样本中鉴定出金黄色葡萄球菌，共有 761 名参与者同意进行初级保健记录审查，并完成了分析所需的完整数据。在过去 2 个月内使用任何抗生素与 MRSA 分离均无关联，调整后的优势比（aOR）为 1.33 [95%置信区间（CI）0.12-15；P=0.8]。在过去 12 个月内使用任何抗生素与 MRSA 之间存在关联的迹象，aOR 为 2.45（95%CI 0.95-6.3；P=0.06）。总之，有迹象表明，在 12 个月内开具的抗生素与 MRSA 的携带有关，但在 2 个月内无关，尽管 2 个月的分析数据对象较少，因此无法检测到这种关联。一项更大的研究将能够进一步阐明这些关联。
