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耐甲氧西林金黄色葡萄球菌:影响不止于皮肤。

Methicillin-Resistant Staphylococcus aureus: The Effects Are More Than Skin Deep.

机构信息

Department of Pediatrics, Washington University School of Medicine, St. Louis, MO.

The George Warren Brown School of Social Work, Washington University, St. Louis, MO.

出版信息

J Pediatr. 2018 Aug;199:158-165. doi: 10.1016/j.jpeds.2018.04.002. Epub 2018 May 11.

Abstract

OBJECTIVES

To assess the psychosocial effects of a methicillin-resistant Staphylococcus aureus (MRSA) diagnosis on the households of children with MRSA skin and soft tissue infection (SSTI).

STUDY DESIGN

We constructed and administered an interview to the primary caregiver within the home of a child with a history of MRSA SSTI.

RESULTS

Seventy-six households were enrolled. Survey responses were analyzed and grouped into 4 themes: health behavior changes, disclosure, social interactions, and knowledge/awareness. The most common theme was disclosure; 91% of participants reported sharing their child's MRSA diagnosis with someone outside of the household. Forty-two percent of respondents reported a change in the manner in which household contacts interacted as a result of the index patient's MRSA diagnosis, including isolating the index patient from other children in the household. Many households reported adopting enhanced personal hygiene behaviors and environmental cleaning routines. Thirty-eight percent of participating households reported altering how they interact with people outside of their home, largely to avoid spreading MRSA to vulnerable individuals. In addition, many participants perceived that others regarded them with caution, especially at daycare, whereas other affected households were excluded from family gatherings.

CONCLUSION

Primary caregivers of children with MRSA SSTI reported changing their health behaviors, altering their interactions with people outside of their home, and feeling isolated by others in response to their child's MRSA diagnosis. The findings of our study highlight a need for community interventions and education to prevent the negative psychosocial repercussions associated with MRSA.

摘要

目的

评估耐甲氧西林金黄色葡萄球菌 (MRSA) 诊断对儿童 MRSA 皮肤软组织感染 (SSTI) 家庭的心理社会影响。

研究设计

我们为有 MRSA SSTI 病史的儿童家庭中的主要照顾者构建并进行了访谈。

结果

共纳入 76 户家庭。对调查结果进行了分析并分为 4 个主题:健康行为改变、披露、社会互动和知识/意识。最常见的主题是披露;91%的参与者报告向家庭以外的人分享了他们孩子的 MRSA 诊断。42%的受访者报告说,由于索引患者的 MRSA 诊断,家庭接触者的互动方式发生了变化,包括将索引患者与家庭中的其他儿童隔离开来。许多家庭报告采用了增强的个人卫生行为和环境清洁常规。38%的参与家庭报告改变了与家庭以外的人互动的方式,主要是为了避免将 MRSA 传播给弱势群体。此外,许多参与者认为其他人对他们持谨慎态度,尤其是在日托中心,而其他受影响的家庭则被排除在家庭聚会之外。

结论

儿童 MRSA SSTI 的主要照顾者报告说,他们改变了健康行为,改变了与家庭以外的人的互动方式,并因孩子的 MRSA 诊断而感到被他人孤立。我们的研究结果强调了需要社区干预和教育,以防止与 MRSA 相关的负面心理社会影响。

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