1Department of Medicine,Public Health Sciences,University of Chicago,Chicago,Illinois.
3Department of Public Health Sciences,University of Chicago,Chicago,Illinois.
Infect Control Hosp Epidemiol. 2017 Oct;38(10):1226-1234. doi: 10.1017/ice.2017.177.
OBJECTIVE To examine trends in Staphylococcus aureus infections in adults and children at a single academic center in 2006-2014. DESIGN Retrospective cohort study. SETTING Inpatient, outpatient, and emergency department settings in a private, tertiary referral center. PATIENTS Patients with an infection culture that grew S. aureus in January 1, 2006, through March 31, 2014. METHODS The first isolate per year for each patient was classified as community-associated (CA-), healthcare-associated (HA-), or HA-community-onset S. aureus. The incidence density of S. aureus, methicillin-susceptible S. aureus (MSSA), and methicillin-resistant S. aureus (MRSA) infections were calculated per quarter year. RESULTS Overall, 5,491 MRSA and 5,398 MSSA isolates were included. MRSA infections decreased by an average of 5.2% annually (P<.001). MRSA skin and soft-tissue infection (SSTI) incidence density decreased in adults (-3.5%; P<.001) and children (-2.9%; P=.004). MSSA infections at all anatomic sites increased by an average of 1.9% annually (P=.007) in adults and decreased 5.1% annually (P<.001) in children. MSSA SSTI incidence density increased in adults (+3.8%; P<.001) and children (+5.6%; P<.001). For MRSA and MSSA SSTI isolates, susceptibility to tetracycline and clindamycin decreased significantly. CONCLUSIONS In 2006-2014, MRSA SSTI incidence decreased among children and adults. MSSA SSTI incidence density increased in children and adults, suggesting that current empiric SSTI treatment recommendations may not be optimal. Adults experienced an overall increase in MSSA infections, which may prompt consideration of the need for horizontal infection control practices to decrease MSSA infection risk. Infect Control Hosp Epidemiol 2017;38:1226-1234.
在 2006-2014 年，于一所学术中心研究成人和儿童金黄色葡萄球菌感染的趋势。
回顾性队列研究。
私立的三级转诊中心的住院部、门诊部和急诊部。
2006 年 1 月 1 日至 2014 年 3 月 31 日期间，感染培养出金黄色葡萄球菌的患者。
将每位患者每年的第一个分离株分为社区获得性（CA-）、医疗保健相关性（HA-）或 HA-社区发病的金黄色葡萄球菌。每季度计算金黄色葡萄球菌、甲氧西林敏感金黄色葡萄球菌（MSSA）和耐甲氧西林金黄色葡萄球菌（MRSA）感染的发病率密度。
共纳入 5491 株 MRSA 和 5398 株 MSSA 分离株。MRSA 感染的年平均下降率为 5.2%（P<.001）。MRSA 皮肤和软组织感染（SSTI）的发病率密度在成人（-3.5%；P<.001）和儿童（-2.9%；P=.004）中均降低。各解剖部位的 MSSA 感染的年平均增长率为 1.9%（P=.007），而儿童的增长率为 5.1%（P<.001）。成人和儿童的 MSSA SSTI 发病率密度均增加（成人：+3.8%；P<.001；儿童：+5.6%；P<.001）。对于 MRSA 和 MSSA SSTI 分离株，对四环素和克林霉素的敏感性显著降低。
2006-2014 年，儿童和成人的 MRSA SSTI 发病率下降。儿童和成人的 MSSA SSTI 发病率密度增加，表明目前的经验性 SSTI 治疗推荐可能并不理想。成人的 MSSA 感染总体增加，可能提示需要采取横向感染控制措施来降低 MSSA 感染风险。感染控制与医院流行病学 2017；38:1226-1234。
