邻里剥夺指数是金黄色葡萄球菌感染的危险因素吗？
Is neighborhood deprivation index a risk factor for Staphylococcus aureus infections?
机构信息
Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Health Services Cost Review Commission, MD.
出版信息
Am J Infect Control. 2023 Dec;51(12):1314-1320. doi: 10.1016/j.ajic.2023.07.001. Epub 2023 Jul 20.
BACKGROUND
We assessed the association between neighborhood area deprivation index (ADI) and community-onset (co) and hospital-onset (ho) Staphylococcus aureus infection.
METHODS
Demographic and clinical characteristics of patients admitted to 5 adult hospitals in the mid-Atlantic between 2016 and 2018 were obtained. The association of ADI with methicillin-resistant (MRSA) and methicillin-sensitive (MSSA) S aureus infections was assessed using logistic regression models adjusting for severity of illness and days of admission.
RESULTS
Overall, increasing ADI was associated with higher odds of co- and ho-MRSA and MSSA infection. In univariate analysis, Black race was associated with 44% greater odds of ho-MRSA infection (odds ratio [OR] 1.44; 95% CI 1.18-1.76) and Asian race (co-MRSA OR 0.355; Confidence Interval (CI) 0.240-0.525; co-MSSA OR 0.718; CI 0.557-0.928) and unknown race (co-MRSA OR 0.470; CI 0.365-0.606; co-MSSA OR 0.699; CI 0.577-0.848) was associated with lower odds of co-MSSA and co-MRSA infections. When both race and ADI were included in the model, Black race was no longer associated with ho-MRSA infections whereas Asian and unknown race remained associated with lower odds of co-MRSA and co-MSSA infection. In the multivariable logistic regression, ADI was consistently associated with increased odds of S aureus infection (co-MRSA OR 1.132; CI 1.064-1.205; co-MSSA OR 1.089; CI 1.030-1.15; ho-MRSA OR 1.29; CI 1.16-1.43: ho-MSSA OR 1.215; CI 1.096-1.346).
CONCLUSIONS
The area deprivation index is associated with community and hospital-onset MRSA and MSSA infections.
背景
我们评估了社区获得性（co）和医院获得性（ho）金黄色葡萄球菌感染与社区区域剥夺指数（ADI）之间的关系。
方法
获取了 2016 年至 2018 年期间在中大西洋地区 5 家成人医院住院的患者的人口统计学和临床特征。使用逻辑回归模型调整疾病严重程度和住院天数后，评估 ADI 与耐甲氧西林金黄色葡萄球菌（MRSA）和甲氧西林敏感金黄色葡萄球菌（MSSA）感染的相关性。
结果
总体而言，ADI 的增加与 co 和 ho-MRSA 和 MSSA 感染的可能性更高相关。在单变量分析中，黑人种族与 ho-MRSA 感染的可能性增加了 44%（优势比[OR]1.44；95%置信区间[CI]1.18-1.76），而亚洲种族（co-MRSA OR 0.355；CI 0.240-0.525；co-MSSA OR 0.718；CI 0.557-0.928）和未知种族（co-MRSA OR 0.470；CI 0.365-0.606；co-MSSA OR 0.699；CI 0.577-0.848）与 co-MSSA 和 co-MRSA 感染的可能性降低相关。当种族和 ADI 都包含在模型中时，黑人种族与 ho-MRSA 感染不再相关，而亚洲和未知种族与 co-MRSA 和 co-MSSA 感染的可能性降低相关。在多变量逻辑回归中，ADI 始终与金黄色葡萄球菌感染的可能性增加相关（co-MRSA OR 1.132；CI 1.064-1.205；co-MSSA OR 1.089；CI 1.030-1.15；ho-MRSA OR 1.29；CI 1.16-1.43：ho-MSSA OR 1.215；CI 1.096-1.346）。
结论
区域剥夺指数与社区和医院获得性 MRSA 和 MSSA 感染有关。
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