Blanco Natalia, Perencevich Eli, Li Shan Shan, Morgan Daniel J, Pineles Lisa, Johnson J Kristie, Robinson Gwen, Anderson Deverick J, Jacob Jesse T, Maragakis Lisa L, Harris Anthony D
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, United States of America.
Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, United States of America.
PLoS One. 2017 May 30;12(5):e0178254. doi: 10.1371/journal.pone.0178254. eCollection 2017.
Little is known about the effect of meteorological conditions and geographical location on bacterial colonization rates particularly of antibiotic-resistant Gram-positive bacteria. We aimed to evaluate the effect of season, meteorological factors, and geographic location on methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) colonization.
The prospective cohort included all adults admitted to 20 geographically-dispersed ICUs across the US from September 1, 2011 to October 4, 2012. Nasal and perianal swabs were collected at admission and tested for MRSA and VRE colonization respectively. Poisson regression models using monthly aggregated colonization counts as the outcome and mean temperature, relative humidity, total precipitation, season, and/or latitude as predictors were constructed for each pathogen.
A total of 24,704 ICU-admitted patients were tested for MRSA and 24,468 for VRE. On admission, 10% of patients were colonized with MRSA and 12% with VRE. For MRSA and VRE, a 10% increase in relative humidity was associated with approximately a 9% increase in prevalence rate. Southerly latitudes in the US were associated with higher MRSA colonization, while northerly latitudes were associated with higher VRE colonization. In contrast to MRSA, the association between VRE colonization and latitude was observed only after adjusting for relative humidity, which demonstrates how this effect is highly driven by this meteorological factor.
To our knowledge, we are the first to study the effect of meteorological factors and geographical location/latitude on MRSA and VRE colonization in adults. Increasing humidity was associated with greater MRSA and VRE colonization. Southerly latitudes in the US were associated with greater MRSA and less VRE. The effect of these factors on MRSA and VRE rates has the potential not only to inform patient management and treatment, but also infection prevention interventions.
关于气象条件和地理位置对细菌定植率的影响，尤其是对抗生素耐药革兰氏阳性菌定植率的影响，目前所知甚少。我们旨在评估季节、气象因素和地理位置对耐甲氧西林金黄色葡萄球菌（MRSA）和耐万古霉素肠球菌（VRE）定植的影响。
前瞻性队列研究纳入了2011年9月1日至2012年10月4日期间美国各地20个地理位置分散的重症监护病房收治的所有成年患者。入院时采集鼻拭子和肛周拭子，分别检测MRSA和VRE定植情况。针对每种病原体构建泊松回归模型，以每月汇总的定植计数为结果，以平均温度、相对湿度、总降水量、季节和/或纬度作为预测因素。
共有24704例入住重症监护病房的患者接受了MRSA检测，24468例接受了VRE检测。入院时，10%的患者感染了MRSA，12%的患者感染了VRE。对于MRSA和VRE，相对湿度每增加10%，患病率约增加9%。美国南部纬度地区与较高的MRSA定植率相关，而北部纬度地区与较高的VRE定植率相关。与MRSA不同，仅在调整相对湿度后才观察到VRE定植与纬度之间的关联，这表明这种影响在很大程度上受该气象因素驱动。
据我们所知，我们是首个研究气象因素和地理位置/纬度对成人MRSA和VRE定植影响的研究。湿度增加与更高的MRSA和VRE定植率相关。美国南部纬度地区与更高的MRSA定植率和更低的VRE定植率相关。这些因素对MRSA和VRE发生率的影响不仅有可能为患者管理和治疗提供依据，也可为感染预防干预措施提供依据。
