糖尿病足感染中耐甲氧西林金黄色葡萄球菌的危险因素。
Risk factors for methicillin-resistant Staphylococcus aureus in diabetic foot infections.
作者信息
Lavery Lawrence A, Fontaine Javier La, Bhavan Kavita, Kim Paul J, Williams Jayme R, Hunt Nathan A
机构信息
Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Division of Infectious Disease, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
出版信息
Diabet Foot Ankle. 2014 Apr 10;5. doi: 10.3402/dfa.v5.23575. eCollection 2014.
OBJECTIVE
The purpose of this study was to evaluate risk factors for methicillin-resistant Staphylococcus aureus (MRSA) in patients hospitalized for diabetic foot infections.
METHODS
We reviewed hospital admissions for foot infections in patients with diabetes which had nasal swabs, and anaerobic and aerobic tissue cultures at the time of admission. Data collected included patient characteristics and medical history to determine risk factors for developing an MRSA infection in the foot.
RESULTS
The prevalence of MRSA in these infections was 29.8%. Risk factors for MRSA diabetic foot infections were history of MRSA foot infection, MRSA nasal colonization, and multidrug-resistant organisms (p<0.05). Positive predictive value (PPV) and negative predictive value (NPV) of nasal colonization with MRSA to identify MRSA diabetic foot infections were 66.7% and 80.0% (sensitivity 41%, specificity 90%). Admission from a nursing home was not a significant risk factor.
CONCLUSION
Positive nasal swabs are not predictive of the infecting agent; however, a negative nasal swab rules out MRSA as the infecting agent in foot wounds with 90% accuracy.
目的
本研究旨在评估因糖尿病足感染住院患者中耐甲氧西林金黄色葡萄球菌（MRSA）的危险因素。
方法
我们回顾了糖尿病足感染患者的住院情况，这些患者入院时进行了鼻拭子检查以及厌氧和需氧组织培养。收集的数据包括患者特征和病史，以确定足部发生MRSA感染的危险因素。
结果
这些感染中MRSA的患病率为29.8%。MRSA糖尿病足感染的危险因素为MRSA足部感染史、MRSA鼻腔定植和多重耐药菌（p<0.05）。MRSA鼻腔定植用于识别MRSA糖尿病足感染的阳性预测值（PPV）和阴性预测值（NPV）分别为66.7%和80.0%（敏感性41%，特异性90%）。从养老院入院不是一个显著的危险因素。
结论
鼻拭子阳性不能预测感染病原体；然而，鼻拭子阴性可排除MRSA作为足部伤口感染病原体，准确率达90%。
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