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哥伦比亚波哥大一家大学医院心血管手术患者的耐甲氧西林金黄色葡萄球菌鼻腔定植情况。

Methicillin-resistant Staphylococcus aureus nasal colonization in cardiovascular surgery patients at a university hospital in Bogotá, Colombia.

作者信息

Martínez-Díaz Heidy C, Valderrama-Beltrán Sandra L, Hernández Ana C, Pinedo Silvia K, Correa Juan R, Ríos Édgar G, Rojas Julie J, Hernández Yessica Y, Hidalgo Marylin

机构信息

Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia; Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia; Unidad de Cirugía Cardiovascular, Hospital Universitario San Ignacio, Bogotá, D.C., Colombia; Maestría en Ciencias - Microbiología, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.

Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia.

出版信息

Biomedica. 2020 May 1;40(Supl. 1):37-44. doi: 10.7705/biomedica.4791.

Abstract

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is a microorganism that colonizes nostrils and different parts of the body, which is considered a risk factor to acquire invasive infections, especially in cardiovascular surgery patients. Objective: To determine the frequency of nasal colonization by MRSA and to establish the clinical characteristics in patients scheduled for cardiovascular surgery. Materials and methods: This was a descriptive study conducted between February and December, 2015. We included adult patients scheduled for cardiovascular surgery at the Hospital Universitario San Ignacio in Bogotá, Colombia. Colonization was identified by real-time PCR from nasal swabs. Colonized patients were treated with mupirocin 2.0% intranasally twice a day and bathed with chlorhexidine 4% from the neck downwards for five days. At the end of this treatment, PCR control was carried out. Results: We included 141 patients with a percentage of nasal colonization of 13.4% (19/141). There were 52 hospitalized patients and 89 outpatients with a percentage of nasal colonization of 17.3% (9/52), and 11.2% (10/89), respectively. All colonized patients who received treatment had a negative PCR at the end of the regime and none of the participating patients had a surgical site infection by S. aureus at the end of the study. Conclusions: Nasal colonization was observed both in hospitalized patients and outpatients. Decolonization treatment with mupirocin was effective to eradicate the carrier state in the short term, which could impact the rates of surgical wound infection associated with cardiovascular surgery.

摘要

引言

耐甲氧西林金黄色葡萄球菌(MRSA)是一种定植于鼻腔和身体不同部位的微生物,被认为是引发侵袭性感染的危险因素,尤其是在心血管手术患者中。目的:确定MRSA鼻腔定植的频率,并确定计划进行心血管手术患者的临床特征。材料与方法:这是一项于2015年2月至12月开展的描述性研究。我们纳入了哥伦比亚波哥大圣伊格纳西奥大学医院计划进行心血管手术的成年患者。通过对鼻拭子进行实时PCR来确定定植情况。对定植患者每天两次鼻内使用2.0%的莫匹罗星进行治疗,并从颈部以下用4%的氯己定进行沐浴,持续五天。在该治疗结束时,进行PCR对照。结果:我们纳入了141名患者,鼻腔定植率为13.4%(19/141)。其中有52名住院患者和89名门诊患者,鼻腔定植率分别为17.3%(9/52)和11.2%(10/89)。所有接受治疗的定植患者在治疗方案结束时PCR检测均为阴性,且在研究结束时,所有参与患者均未发生金黄色葡萄球菌手术部位感染。结论:在住院患者和门诊患者中均观察到鼻腔定植情况。使用莫匹罗星进行去定植治疗在短期内有效根除了携带状态,这可能会影响与心血管手术相关的手术伤口感染率。

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