Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL, 60153, USA.
Biostatistics Core Clinical Research Office, Loyola University Chicago Health Sciences Division Center for Translational Research and Education, Chicago, IL, USA.
Arch Gynecol Obstet. 2023 Apr;307(4):1203-1208. doi: 10.1007/s00404-022-06552-x. Epub 2022 Apr 9.
To assess the incidence of MRSA positive patients in pregnancy, as well as the postpartum outcomes in MRSA positive patients.
This is a retrospective cohort study of women who underwent universal MRSA universal at a tertiary medical center. A MRSA swab was routinely collected as part of the patient's prenatal care at 35-37 weeks gestation or on admission to labor and delivery. Demographic information and decolonization antibiotics were collected by electronic medical record review, using ICD-9 codes. Outcome data were collected, including mode of delivery, hospital length of stay, endometritis, wound cellulitis, and wound infection. p < 0.05 was considered significant. A univariate logistic regression and a multivariable binary logistic regression model were used to analyze the strength of association between outcomes and MRSA status. Statistical analysis was performed with SAS, version 9.4.
The incidence of MRSA during the 4 year study period was 1.9% (82 MRSA positive out of 4369 total patients). 90.2% (74/82) of MRSA positive patients received decolonization antibiotics. No difference was noted in mode of delivery. Logistic regression failed to identify any significant differences in other relevant outcomes for MRSA positive women including endometritis 1.1 (0.1-17.5) [positive 0, versus negative 0.6% (n = 24)], wound cellulitis 5.9 (0.4-82.1) positive 0, versus negative 0.1% (Gorwitz et al. in J Infect Dis 197:1226-1234, 2008) and wound infection 3.3 (0.6-16.9) [positive 1.2%, versus negative 0.5% ( in Am J Infect Control 32:470-85, 2004)] when compared to MRSA negative women.
When universal MRSA screening was performed at an academic tertiary care center, the overall incidence of MRSA was low. MRSA positive and subsequently decolinzed patients did not have any identified increase in postpartum infectious morbidity, as compared to MRSA negative patients.
评估妊娠合并耐甲氧西林金黄色葡萄球菌（MRSA）阳性患者的发生率，以及 MRSA 阳性患者的产后结局。
这是一项对在三级医疗中心进行普遍 MRSA 检测的孕妇的回顾性队列研究。MRSA 拭子作为患者产前护理的一部分，在 35-37 周妊娠或入院分娩时常规采集。通过电子病历回顾收集人口统计学信息和去定植抗生素，使用 ICD-9 代码。收集结局数据，包括分娩方式、住院时间、子宫内膜炎、伤口蜂窝织炎和伤口感染。p<0.05 为差异有统计学意义。使用单变量逻辑回归和多变量二元逻辑回归模型分析结局与 MRSA 状态之间的关联强度。使用 SAS 版本 9.4 进行统计分析。
在 4 年的研究期间，MRSA 的发生率为 1.9%（4369 例患者中 82 例 MRSA 阳性）。90.2%（74/82）的 MRSA 阳性患者接受了去定植抗生素。分娩方式无差异。逻辑回归未发现 MRSA 阳性妇女其他相关结局的显著差异，包括子宫内膜炎 1.1（0.1-17.5）[阳性 0，阴性 0.6%（n=24）]、伤口蜂窝织炎 5.9（0.4-82.1）阳性 0，阴性 0.1%（Gorwitz 等人，《感染性疾病杂志》197：1226-1234，2008）和伤口感染 3.3（0.6-16.9）[阳性 1.2%，阴性 0.5%（《美国感染控制杂志》32：470-85，2004）]，与 MRSA 阴性妇女相比。
在学术性三级保健中心进行普遍的 MRSA 筛查时，MRSA 的总体发生率较低。与 MRSA 阴性患者相比，MRSA 阳性且随后去定植的患者产后感染发病率没有任何增加。
