泰国常规血液透析患者中金黄色葡萄球菌鼻腔携带和血流感染：一项前瞻性多中心队列研究。

Staphylococcus aureus nasal carriage and bloodstream infection among conventional hemodialysis patients in Thailand: a prospective multicenter cohort study.

机构信息

Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.

Department of Internal Medicine, Ananda Mahidol Hospital, Lopburi, Thailand.

出版信息

BMC Res Notes. 2022 Sep 6;15(1):290. doi: 10.1186/s13104-022-06185-y.

DOI:10.1186/s13104-022-06185-y

PMID:36068640

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9450322/

Abstract

OBJECTIVE

Staphylococcus aureus nasal carriage screening among hemodialysis patients is not standard practice in Thailand, because of data lacking regarding prevalence and correlation with subsequent infection. We aimed to investigate the prevalence of S. aureus nasal carriage and its association with bloodstream infection among hemodialysis patients. In this prospective multicenter cohort study, participants were screened for S. aureus nasal carriage over 2 consecutive weeks. Incidence of S. aureus bloodstream infection over the next 12 months was observed.

RESULTS

The prevalence of S. aureus nasal carriage was 11.67%. Incidence of S. aureus bacteremia among participants with and without S. aureus nasal carriage were 7.1% and 3.8%, respectively. The odds ratio for nasal carriage and subsequent bacteremia was 1.96 (95% CI 0.04-21.79; p = 0.553). Survival analysis showed that time to bacteremia among participants in the two groups did not significantly differ (p = 0.531). Prevalence of S. aureus nasal carriage among hemodialysis patients in Thailand was low. Patients presenting with S. aureus nasal carriage did not have increased risk of S. aureus bacteremia after 12-month follow-up. Nasal S. aureus screening and decolonization should not be encouraged in this setting.

摘要

目的

由于缺乏有关泰国地区金黄色葡萄球菌鼻腔携带率以及与后续感染相关性的数据，因此在血液透析患者中，金黄色葡萄球菌鼻腔筛查并非标准操作。我们旨在研究金黄色葡萄球菌鼻腔携带率及其与血液透析患者血流感染的相关性。在这项前瞻性多中心队列研究中，参与者连续 2 周接受金黄色葡萄球菌鼻腔携带筛查。观察接下来 12 个月内金黄色葡萄球菌血流感染的发生率。

结果

金黄色葡萄球菌鼻腔携带率为 11.67%。有和没有金黄色葡萄球菌鼻腔携带的参与者中金黄色葡萄球菌菌血症的发生率分别为 7.1%和 3.8%。鼻腔携带与后续菌血症的比值比为 1.96（95%CI 0.04-21.79；p=0.553）。生存分析显示，两组参与者的菌血症时间无显著差异（p=0.531）。泰国血液透析患者金黄色葡萄球菌鼻腔携带率较低。在 12 个月随访后，携带金黄色葡萄球菌的患者发生金黄色葡萄球菌菌血症的风险并未增加。在这种情况下，不应鼓励进行鼻腔金黄色葡萄球菌筛查和去定植。