安大略省西北部侵袭性社区获得性耐甲氧西林金黄色葡萄球菌：一项为期2年的前瞻性研究。
Invasive CA-MRSA in northwestern Ontario: a 2-year prospective study.
作者信息
Kirlew Mike, Rea Sara, Schroeter Annette, Makahnouk Donna, Hamilton Marsha, Brunton Nicole, Muileboom Jill, Schreiber Yoko, Saginur Raphael, Kelly Len
机构信息
Division of Clinical Sciences, Northern Ontario School of Medicine, Sioux Lookout, Ont.
Anishnaabe Bimaadiziwin Research Unit, Sioux Lookout Meno Ya Win Health Centre; Sioux Lookout First Nations Health Authority, Sioux Lookout, Ont.
出版信息
Can J Rural Med. 2014 Summer;19(3):99-102.
INTRODUCTION
Northwestern Ontario has a documented high rate of skin and soft-tissue infections due to community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). Recently, invasive illness from this common pathogen has become a serious clinical problem in the region. We sought to better understand this trend of invasive CA-MRSA.
METHODS
We prospectively studied cases of positive CA-MRSA bacteremia in 2012 and 2013. We examined genetic typing, comorbidities and outcomes.
RESULTS
Twenty-three cases of CA-MRSA bacteremia were treated during the 2-year study period. Intravenous drug use accounted for only 17% of cases. One death and 2 cases of endocarditis occurred.
CONCLUSION
High rates of CA-MRSA in skin and soft-tissue infections, combined with poor living conditions and poor access to potable water, may account for most of these cases of CA-MRSA bacteremia. Social determinants of health are relevant when common resistant bacterial isolates become associated with life-threatening illness.
引言
安大略省西北部有记录表明，社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）导致的皮肤和软组织感染发病率很高。最近，这种常见病原体引起的侵袭性疾病在该地区已成为一个严重的临床问题。我们试图更好地了解侵袭性CA-MRSA的这一趋势。
方法
我们对2012年和2013年CA-MRSA菌血症阳性病例进行了前瞻性研究。我们检查了基因分型、合并症和结局。
结果
在为期2年的研究期间，共治疗了23例CA-MRSA菌血症病例。静脉吸毒仅占病例的17%。发生了1例死亡和2例心内膜炎。
结论
皮肤和软组织感染中CA-MRSA的高发病率，再加上生活条件差和饮用水供应不足，可能是这些CA-MRSA菌血症病例的主要原因。当常见的耐药细菌分离株与危及生命的疾病相关联时，健康的社会决定因素就很重要了。
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