台湾地区终末期肾病患者耐甲氧西林金黄色葡萄球菌鼻腔携带的危险因素。
Risk factors for nasal carriage of methicillin-resistant Staphylococcus aureus among patients with end-stage renal disease in Taiwan.
机构信息
Department of Internal Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University, Taipei, Taiwan.
出版信息
J Formos Med Assoc. 2012 Jan;111(1):14-8. doi: 10.1016/j.jfma.2012.01.001. Epub 2012 Jan 30.
BACKGROUND/PURPOSE: Patients with end-stage renal disease (ESRD) are at particular risk for methicillin-resistant Staphylococcus aureus (MRSA) infections, especially via nasal colonization of MRSA. Surveillance cultures are recommended to identify patients colonized by MRSA.
METHODS
Clinical data and screening cultures of S. aureus from the anterior nares of 541 patients on long-term dialysis in the hospitals were performed in March 2007. The follow-up survey was conducted 1 year later.
RESULTS
A total of 32 (5.9%) of the 541 patients were positive nasal cultures for MRSA, while 89 (16.5%) were positive for methicillin-susceptible S. aureus (MSSA). In a multivariate analysis, risk factors for ESRD patients with MRSA colonization included congestive heart failure, nursing home admission, and nasogastric tube feeding in the last 3 months. Follow-up of the 32 MRSA colonized patients showed that one (3.1%) died due to MSSA and three (9.3%) died due from MRSA infection.
CONCLUSIONS
We found that patients with ESRD and MRSA nasal colonization were associated with a history of congestive heart failure, nursing home admission, and nasogastric tube feeding in the last 3 months.
背景/目的：终末期肾病（ESRD）患者尤其容易发生耐甲氧西林金黄色葡萄球菌（MRSA）感染，尤其是通过鼻腔 MRSA 定植。建议进行监测培养以识别 MRSA 定植的患者。
方法
2007 年 3 月对长期透析于医院的 541 例患者的鼻前庭临床数据和金黄色葡萄球菌筛查培养进行了研究。1 年后进行了随访调查。
结果
541 例患者中，共有 32 例（5.9%）对 MRSA 鼻腔培养呈阳性，而 89 例（16.5%）对甲氧西林敏感金黄色葡萄球菌（MSSA）呈阳性。多变量分析显示，ESRD 患者 MRSA 定植的危险因素包括充血性心力衰竭、养老院入院和过去 3 个月内经鼻胃管喂养。对 32 例 MRSA 定植患者的随访显示，1 例（3.1%）死于 MSSA，3 例（9.3%）死于 MRSA 感染。
结论
我们发现，患有 ESRD 并伴有鼻腔 MRSA 定植的患者与充血性心力衰竭、养老院入院和过去 3 个月内经鼻胃管喂养的病史有关。
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