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纽约六个社区健康中心中,美国出生人群与非美国出生人群在社区获得性耐甲氧西林金黄色葡萄球菌(MRSA)和甲氧西林敏感金黄色葡萄球菌(MSSA)患病率上的差异。

Differences in prevalence of community-associated MRSA and MSSA among U.S. and non-U.S. born populations in six New York Community Health Centers.

作者信息

Piper Jenks N, Pardos de la Gandara M, D'Orazio B M, Correa da Rosa J, Kost R G, Khalida C, Vasquez K S, Coffran C, Pastagia M, Evering T H, Parola C, Urban T, Salvato S, Barsanti F, Coller B S, Tobin J N

机构信息

Clinical Directors Network, Inc (CDN), 5 West 37th Street, 10th Floor, New York, NY 10018, USA; Hudson River HealthCare, 1037 Main Street, Peekskill, NY 10566, USA.

Laboratory of Microbiology & Infectious Diseases, The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA.

出版信息

Travel Med Infect Dis. 2016 Nov-Dec;14(6):551-560. doi: 10.1016/j.tmaid.2016.10.003. Epub 2016 Oct 20.

Abstract

BACKGROUND

Staphylococcus aureus is the most common cause of Skin and Soft Tissue Infections (SSTIs) in the community in the United States of America. Community Health Centers (CHC) serve as primary care providers for thousands of immigrants in New York.

METHODS

As part of a research collaborative, 6 New York City-area CHCs recruited patients with SSTIs. Characterization was performed in all S. aureus isolates from wounds and nasal swabs collected from patients. Statistical analysis examined the differences in wound and nasal cultures among immigrant compared to native-born patients.

RESULTS

Wound and nasal specimens were recovered from 129 patients and tested for antibiotic susceptibility. 40 patients were immigrants from 15 different countries. Although not statistically significant, immigrants had lower rates of MRSA infections (n = 15) than did native-born participants, and immigrants showed significantly higher rates of MSSA wound cultures (n = 11) (OR = 3.5, 95% CI: 1.3, 9.7).

CONCLUSIONS

In our study, immigrants were more likely to present with SSTIs caused by MSSA than US-born patients. Immigants also reported lower frequencies of antibiotic prescription or consumption in the months prior to SSTI infection. This suggests that antibiotic resistance may vary regionally and that immigrants presenting with SSTIs may benefit from a broader range of antibiotics.

摘要

背景

在美国社区中,金黄色葡萄球菌是皮肤和软组织感染(SSTIs)最常见的病因。社区健康中心(CHC)为纽约数千名移民提供初级医疗服务。

方法

作为一项研究合作的一部分,6家纽约市地区的社区健康中心招募了患有皮肤和软组织感染的患者。对从患者伤口和鼻拭子中分离出的所有金黄色葡萄球菌进行特征分析。统计分析检验了移民患者与本土出生患者伤口和鼻腔培养结果的差异。

结果

从129名患者身上采集了伤口和鼻拭子样本并检测其抗生素敏感性。40名患者为来自15个不同国家的移民。尽管差异无统计学意义,但移民的耐甲氧西林金黄色葡萄球菌(MRSA)感染率(n = 15)低于本土出生的参与者,且移民的甲氧西林敏感金黄色葡萄球菌(MSSA)伤口培养阳性率显著更高(n = 11)(比值比= 3.5,95%置信区间:1.3,9.7)。

结论

在我们的研究中,与美国本土出生的患者相比,移民更有可能出现由甲氧西林敏感金黄色葡萄球菌引起的皮肤和软组织感染。移民在皮肤和软组织感染前几个月报告的抗生素处方或使用频率也较低。这表明抗生素耐药性可能存在地区差异,且出现皮肤和软组织感染的移民可能会从更广泛的抗生素治疗中获益。

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