Leamer Nicole K, Clemmons Nakia S, Jordan Nikki N, Pacha Laura A
Disease Epidemiology Program, U.S. Army Public Health Command, 5158 Blackhawk Road, Aberdeen Proving Ground-Edgewood Area, MD 21010-5403, USA.
Mil Med. 2013 Aug;178(8):914-20. doi: 10.7205/MILMED-D-13-00082.
Increasing numbers of Staphylococcus aureus infections demonstrate antibiotic resistance. Military populations experiencing crowding are at increased risk of community-acquired methicillin-resistant S. aureus (CA-MRSA) infection. High prevalence of CA-MRSA infection among Army personnel was previously documented at Fort Benning, GA from 2002 to 2007.
To ascertain recent CA-MRSA trends at Fort Benning regarding antibiotic susceptibility, infection rates, and treatment regimens among Army personnel.
Incident CA-MRSA cases among active duty members/trainees from January 2008 to December 2010 were identified using active surveillance and laboratory data.
In total, 2,171 infections were identified, representing 5,794 CA-MRSA-related clinic visits. Annual rates decreased from 33 to 27 infections per 1,000 soldiers from 2008 to 2010. Approximately 78% of isolates were from training units. Approximately 4% of infections required hospitalization. Most infections (97%) were treated with antibiotics (36% received antibiotics and wound drainage). Antibiotic susceptibility patterns remained comparable to previous assessments.
The observed decline in CA-MRSA rates and associated hospitalizations, coupled with stable antibiotic susceptibility patterns, is encouraging. Passive surveillance using laboratory records proved useful in identifying infection and could enhance detection across training sites. Given the continued high CA-MRSA prevalence among trainees, providers/public health personnel should remain vigilant to bolster prevention, detection, and treatment efforts.
金黄色葡萄球菌感染表现出抗生素耐药性的数量不断增加。经历拥挤状况的军事人群社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)感染风险增加。此前在佐治亚州本宁堡记录了2002年至2007年陆军人员中CA-MRSA感染的高患病率。
确定本宁堡近期关于陆军人员抗生素敏感性、感染率和治疗方案的CA-MRSA趋势。
利用主动监测和实验室数据确定2008年1月至2010年12月现役军人/学员中的CA-MRSA发病病例。
共识别出2171例感染,代表5794次与CA-MRSA相关的门诊就诊。2008年至2010年,年发病率从每1000名士兵33例降至27例。约78%的分离株来自训练单位。约4%的感染需要住院治疗。大多数感染(97%)接受了抗生素治疗(36%接受了抗生素和伤口引流)。抗生素敏感性模式与先前评估结果相当。
观察到的CA-MRSA发病率和相关住院率下降,以及稳定的抗生素敏感性模式,令人鼓舞。利用实验室记录进行的被动监测在识别感染方面被证明是有用的,并且可以加强对各训练地点的检测。鉴于学员中CA-MRSA患病率持续居高不下,医疗服务提供者/公共卫生人员应继续保持警惕,加强预防、检测和治疗工作。