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风湿性疾病患者感染耐甲氧西林金黄色葡萄球菌(MRSA)的风险并未增加。

Patients with Rheumatic Diseases do not have an Increased Risk of MRSA Carrier Status.

作者信息

Krämer Judith, Triantafyllias Konstantinos, Kohnen Wolfgang, Leber Martin, Dederichs-Masius Ute, Zucker Andrea, Körber Jürgen, Schwarting Andreas

机构信息

University Medical Center, Johannes Gutenberg University, Mainz, Germany.

ACURA Rheumatology Center, Bad Kreuznach, Germany.

出版信息

Rheumatol Ther. 2018 Dec;5(2):371-381. doi: 10.1007/s40744-018-0116-4. Epub 2018 Jun 2.

Abstract

INTRODUCTION

The aim of this study was to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) both in rheumatologic and non-rheumatologic rehabilitation centers. In addition, we sought to evaluate the practice value of existing screening recommendations of the German Commission for Hospital Hygiene and Infection Prevention (KRINKO).

METHODS

The analysis was performed in four rehabilitation clinics (rheumatology, psychosomatic medicine, oncology, and cardiology) with at least 200 patients per clinic tested for MRSA.

RESULTS

Nine (1.1%) of the 842 patients were colonized with MRSA. Only five of them should have been tested according to the commission's recommendations. The prevalence was 0.5% (n = 207) in rheumatologic, 0.9% (n = 224) in psychosomatic, 1.4% (n = 209) in oncologic and 1.5% (n = 202) in cardiologic patients. We found a greater exposure to risk factors in cardiologic and oncologic patients. Among patients with carrier status, a higher percentage was exposed to three potential risk factors not applied by the commission.

CONCLUSIONS

The prevalence of MRSA in our cohort correlates with data from previous studies. The low percentage among rheumatologic patients suggests that they are not more likely to reveal MRSA carrier status than other patient groups and that long-term immunosuppression does not necessarily represent a risk factor for MRSA colonization. Since only five out of nine patients with carrier status would have been detected following the recommendations of the KRINKO, further studies on potential risk factors are warranted.

摘要

引言

本研究的目的是确定耐甲氧西林金黄色葡萄球菌(MRSA)在风湿性和非风湿性康复中心的流行情况。此外,我们试图评估德国医院卫生与感染预防委员会(KRINKO)现有筛查建议的实用价值。

方法

对四家康复诊所(风湿病、身心医学、肿瘤学和心脏病学)进行分析,每家诊所至少有200名患者接受了MRSA检测。

结果

842名患者中有9名(1.1%)被MRSA定植。根据委员会的建议,其中只有5名患者应该接受检测。风湿性患者中的患病率为0.5%(n = 207),身心医学患者中为0.9%(n = 224),肿瘤学患者中为1.4%(n = 209),心脏病学患者中为1.5%(n = 202)。我们发现心脏病学和肿瘤学患者接触风险因素的情况更多。在携带者状态的患者中,有更高比例的人接触到委员会未采用的三种潜在风险因素。

结论

我们队列中MRSA的患病率与先前研究的数据相关。风湿性患者中的低比例表明,他们并不比其他患者群体更有可能显示出MRSA携带者状态,而且长期免疫抑制不一定是MRSA定植的风险因素。由于按照KRINKO的建议,9名携带者状态的患者中只有5名会被检测出来,因此有必要对潜在风险因素进行进一步研究。

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