Min Kyoung-Bok, Min Jin-Young
Department of Preventive Medicine, Seoul National University College of Medicine.
Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea.
Medicine (Baltimore). 2019 May;98(18):e15499. doi: 10.1097/MD.0000000000015499.
Given the emergence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) as a global health threat, understanding the risk factors for MRSA infection in the community may be a reasonable strategy to prevent it. We investigated the associations between serum homocysteine levels and prevalence of nasal colonization with S aureus and MRSA among United States adults. We conducted a cross-sectional analysis of a nationally representative sample of 7832 adults (20 years or older). The main outcome variables were nasal colonization with S aureus and MRSA. Percentages of colonization with S aureus and MRSA were calculated by the quartiles of serum homocysteine. A total of 7832 of 2051 subjects (26.2%) were culture positive for S aureus, 98 (4.8%) of whom had nasal colonization with MRSA. In comparison with subjects having the lowest serum homocysteine, the odds of nasal colonization with MRSA were significantly higher in those with the highest homocysteine (odds ratio, 3.09; 95% confidence interval, 1.11-8.61) in multivariate analysis, adjusted for all confounding variables. By contrast, homocysteine elevation was not significantly associated with S aureus colonization. Nasal colonization with MRSA in the general community was significantly associated with increases in serum homocysteine levels.
鉴于社区获得性耐甲氧西林金黄色葡萄球菌（MRSA）已成为全球健康威胁，了解社区中MRSA感染的风险因素可能是预防该感染的合理策略。我们调查了美国成年人血清同型半胱氨酸水平与金黄色葡萄球菌和MRSA鼻腔定植患病率之间的关联。我们对7832名成年人（20岁及以上）的全国代表性样本进行了横断面分析。主要结局变量是金黄色葡萄球菌和MRSA的鼻腔定植。金黄色葡萄球菌和MRSA的定植百分比按血清同型半胱氨酸四分位数计算。2051名受试者中有7832名（26.2%）金黄色葡萄球菌培养呈阳性，其中98名（4.8%）鼻腔定植有MRSA。在多变量分析中，对所有混杂变量进行校正后，与血清同型半胱氨酸水平最低的受试者相比，同型半胱氨酸水平最高的受试者鼻腔定植MRSA的几率显著更高（比值比，3.09；95%置信区间，1.11 - 8.61）。相比之下，同型半胱氨酸升高与金黄色葡萄球菌定植无显著关联。普通社区中MRSA的鼻腔定植与血清同型半胱氨酸水平升高显著相关。
