Chatterjee Aparajita, Rai Shipra, Guddattu Vasudeva, Mukhopadhyay Chiranjay, Saravu Kavitha
Department of Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Madhav Nagar, Karnataka, India,
Department of Statistics, Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, Madhav Nagar, Karnataka, India.
Risk Manag Healthc Policy. 2018 Dec 3;11:243-250. doi: 10.2147/RMHP.S176517. eCollection 2018.
To determine morbidity and mortality of methicillin-resistant (MRSA) and methicillin-sensitive (MSSA) infections in a tertiary health care facility.
A cohort study among hospitalized adult patients with culture proven MRSA or MSSA monoinfection were recruited in a tertiary referral center in South India from November 2011 to December 2012.
Of total 551 subjects, 284 (52%) had MRSA and 267 (48%) MSSA infection. A total of 184 (65%) subjects had health care-associated MRSA (HA-MRSA) and 100 (35%) community-associated MRSA (CA-MRSA). Chronic kidney disease and recent antibiotic use had significant association with MRSA. MRSA patients had significant respiratory infection (OR 2.24 [1.04, 5.16]) and bacteremia (OR 2.24 [10.40, 5.16]), relative to MSSA. MSSA group had better survival function compared to MRSA group (=0.028). Median duration of ICU stays were 5 days (IQR 4, 8) and 2 days (IQR 2, 2) in MRSA and MSSA, respectively. Complications such as acute kidney injury, sepsis, multiorgan dysfunction, need for supportive measures were more in the MRSA group.
MRSA imposes a huge burden in Indian scenario and HA-MRSA remains the main culprit. Patients with history of chronic kidney disease and recent use of antibiotics were found to be at a higher risk. Patients with MRSA infections tend to have poorer outcomes in terms of longer hospital stay, greater complications, and mortality.
确定在一家三级医疗保健机构中耐甲氧西林金黄色葡萄球菌（MRSA）感染和甲氧西林敏感金黄色葡萄球菌（MSSA）感染的发病率和死亡率。
2011年11月至2012年12月，在印度南部的一家三级转诊中心，对成年住院患者中经培养证实为MRSA或MSSA单一感染的患者进行了一项队列研究。
在总共551名受试者中，284名（52%）患有MRSA感染，267名（48%）患有MSSA感染。共有184名（65%）受试者患有医疗保健相关MRSA（HA-MRSA），100名（35%）患有社区相关MRSA（CA-MRSA）。慢性肾病和近期使用抗生素与MRSA感染有显著关联。相对于MSSA，MRSA患者有显著的呼吸道感染（比值比2.24 [1.04, 5.16]）和菌血症（比值比2.24 [10.40, 5.16]）。与MRSA组相比，MSSA组的生存功能更好（P = 0.028）。MRSA组和MSSA组在重症监护病房的中位住院时间分别为5天（四分位间距4, 8）和2天（四分位间距2, 2）。MRSA组的急性肾损伤、脓毒症、多器官功能障碍等并发症以及对支持措施的需求更多。
在印度的情况下，MRSA造成了巨大负担，HA-MRSA仍然是主要罪魁祸首。发现有慢性肾病病史和近期使用抗生素的患者风险更高。MRSA感染患者在住院时间更长、并发症更多和死亡率方面往往预后较差。
