耐甲氧西林金黄色葡萄球菌在德国医院感染中的耐药率下降：一项长达 10 年的前瞻性分析。
Decrease of methicillin resistance in Staphylococcus aureus in nosocomial infections in Germany-a prospective analysis over 10 years.
机构信息
Institute of Hygiene and Environmental Medicine, Charité - University Medicine Berlin, Hindenburgdamm 27, 12203 Berlin, Germany; German National Reference Centre for Surveillance of Nosocomial Infections, Hindenburgdamm 27, 12203 Berlin, Germany.
Institute of Hygiene and Environmental Medicine, Charité - University Medicine Berlin, Hindenburgdamm 27, 12203 Berlin, Germany; German National Reference Centre for Surveillance of Nosocomial Infections, Hindenburgdamm 27, 12203 Berlin, Germany.
出版信息
J Infect. 2019 Mar;78(3):215-219. doi: 10.1016/j.jinf.2018.12.005. Epub 2019 Jan 15.
OBJECTIVES
Methicillin resistant Staphylococcus aureus (MRSA) remains an important cause of healthcare-associated infections. Here, we describe the development of methicillin-resistant isolates among nosocomial Staphylococcus aureus (SA) infections in Germany between 2007 and 2016.
METHODS
We analyzed data from the voluntary German national nosocomial Infection Surveillance System. Data on bloodstream infections (BSI) and lower respiratory tract infections (LRTI) were derived from intensive care units (ICU), whereas data on surgical site infections (SSI) were collected from surgical departments (SD). Univariate analysis was performed on trend of proportion, while multivariable logistic regression was performed to identify risk factors for MRSA-infections.
RESULTS
Data of 1218 ICU and 1,556 SD were included. Overall, a decrease in the proportion of MRSA among all nosocomial SA-infections from 32.8% to 20.0% was noted. MRSA decreased from 37.1% to 21.8% (p = 0.01) for BSI, from 38.7% to 19.2% for LTRI (p < 0.01) and. from 21.1% to 7.4% (p < 0.01) in SSI. Logistic regression revealed that SA-infections in Mecklenburg Western-Pomerania were more likely caused by MRSA (Odds ratio (OR): 2.5; 95% CI: 1.7, 3.6).
CONCLUSION
We observed a significant reduction of the proportion of nosocomial Staphylococcus aureus infections due to MRSA in Germany over the course of the last 10 years.
目的
耐甲氧西林金黄色葡萄球菌（MRSA）仍然是医院获得性感染的重要原因。在此，我们描述了 2007 年至 2016 年德国医院获得性金黄色葡萄球菌（SA）感染中耐甲氧西林分离株的发展情况。
方法
我们分析了自愿参与的德国国家医院感染监测系统的数据。血流感染（BSI）和下呼吸道感染（LRTI）的数据来自重症监护病房（ICU），而手术部位感染（SSI）的数据来自外科病房（SD）。采用单变量分析比例趋势，多变量逻辑回归分析确定 MRSA 感染的危险因素。
结果
共纳入 1218 例 ICU 和 1556 例 SD。总体而言，医院获得性 SA 感染中 MRSA 的比例从 32.8%下降到 20.0%。BSI 中 MRSA 从 37.1%下降到 21.8%（p=0.01），LTRI 从 38.7%下降到 19.2%（p<0.01），SSI 从 21.1%下降到 7.4%（p<0.01）。逻辑回归显示，梅克伦堡-西波美拉尼亚的 SA 感染更有可能由 MRSA 引起（优势比（OR）：2.5；95%置信区间：1.7, 3.6）。
结论
在过去 10 年中，德国医院获得性金黄色葡萄球菌感染中由于 MRSA 导致的比例显著下降。
Zotero 插件