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社区获得性耐甲氧西林金黄色葡萄球菌感染率评估及儿科人群危险因素评估。

Assessment of infections rate due to community-acquired Methicillin-resistant Staphylococcus aureus and evaluation of risk factors in the paediatric population.

机构信息

The Hebrew University Hadassah Medical School, Jerusalem, Israel.

Hadassah Hebrew-University School of Medicine, Jerusalem, Israel.

出版信息

Acta Paediatr. 2021 May;110(5):1579-1584. doi: 10.1111/apa.15698. Epub 2020 Dec 11.

Abstract

AIM

We aimed at assessing the frequency of Community-acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA) infections, identifying its risk factors and evaluating resistance patterns of Staphylococcus aureus to various antibiotics in order to recommend the optimal empirical treatment for suspected Staphylococcus aureus infections.

METHODS

We reviewed the medical records of children who were treated at Shaare Zedek medical centre, located in Jerusalem, Israel, over the years 2008-2019 and had a positive culture for Staphylococcus aureus. Patients with CA-MRSA infections were compared with Methicillin-susceptible Staphylococcus aureus (CA-MSSA) infections.

RESULTS

In this study, 620 paediatric patients were included. The number of children in the CA-MRSA study group was 124, while the MSSA control group consisted of 496 children. Risk factors for CA-MRSA infections included young age (1-5 years), female sex, Arab ethnicity and residence in East Jerusalem. The incidence of CA-MRSA increased over the past decade, with an average of 11.2%. An increase in MSSA resistance to clindamycin was noted while Trimethoprim-Sulphamethoxazole resistance remained low.

CONCLUSION

The incidence of CA-MRSA in Jerusalem was rising, along with changes in resistance patterns of both MSSA and MRSA to various antibiotic agents. In order to optimise empirical treatment for suspected staphylococcal infection, continued monitoring of CA-MRSA prevalence and resistance rates is essential.

摘要

目的

我们旨在评估社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)感染的频率,确定其危险因素,并评估金黄色葡萄球菌对各种抗生素的耐药模式,以便为疑似金黄色葡萄球菌感染推荐最佳的经验性治疗方案。

方法

我们回顾了 2008 年至 2019 年期间在以色列耶路撒冷的 Shaare Zedek 医疗中心接受治疗且金黄色葡萄球菌培养阳性的儿童的病历。将 CA-MRSA 感染患者与甲氧西林敏感金黄色葡萄球菌(CA-MSSA)感染患者进行比较。

结果

本研究共纳入 620 例儿科患者。CA-MRSA 研究组的儿童数量为 124 例,而 MSSA 对照组由 496 例儿童组成。CA-MRSA 感染的危险因素包括年龄较小(1-5 岁)、女性、阿拉伯裔和居住在东耶路撒冷。过去十年,CA-MRSA 的发病率呈上升趋势,平均为 11.2%。同时,MSSA 对克林霉素的耐药率有所增加,而甲氧苄啶-磺胺甲噁唑的耐药率仍保持较低水平。

结论

随着 MSSA 和 MRSA 对各种抗生素的耐药模式发生变化,耶路撒冷的 CA-MRSA 发病率也在上升。为了优化疑似葡萄球菌感染的经验性治疗,持续监测 CA-MRSA 的流行率和耐药率至关重要。

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