Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Orthopedic Surgery, University of Texas Health Science Center, San Antonio, Texas, USA.
Int Wound J. 2024 Sep;21(9):e70039. doi: 10.1111/iwj.70039.
To identify the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection, reinfection and clinical outcomes. Four hundred forty-six patients that were admitted to the hospital with moderate or severe foot infections were retrospectively reviewed. Tissue and bone cultures were obtained from the index hospital admission. Conversion was defined as methicillin susceptible Staphylococcus aureus in the first culture and subsequently MRSA when there was a reinfection. The incidence of MRSA was 7.8% (n = 35), with no significant difference between soft tissue infections (7.7%) and osteomyelitis (8.0%). MRSA incidence was 9.4 times higher in non-diabetics (23.8% vs. 3.2%, p = <0.01). The incidence of reinfection was 40.8% (n = 182). Conversion to MRSA was seen in 2.2% (n = 4) total, occurring in 5.4%. Non-diabetics were 20.1 times more likely to have MRSA reinfection than people with diabetes (28.6% vs. 1.9%, p < 0.001). MRSA patients had a higher proportion of healed wounds (82.4% vs. 69.3%, p = 0.02). There were no differences in other clinical outcomes in MRSA vs. other infections in reinfection (28.6% vs. 24.3%, p = 0.11), amputation (48.6% vs. 52.0%, p = 0.69) or hospitalization (28.6% vs. 42.6, p = 0.11). The incidence of MRSA for the first infection (7.8%), reinfection (6.0%) and conversion to MRSA (2.2%) was low. MRSA was 9.4 times more common in people without diabetes.
确定耐甲氧西林金黄色葡萄球菌（MRSA）感染、再感染和临床结局的发生率。
回顾性分析 446 例因中度或重度足部感染住院的患者。从入院时采集组织和骨培养物。转换定义为首次培养物中为甲氧西林敏感金黄色葡萄球菌，随后再感染时为 MRSA。MRSA 的发生率为 7.8%（n=35），软组织感染（7.7%）和骨髓炎（8.0%）之间无显著差异。非糖尿病患者的 MRSA 发生率高 9.4 倍（23.8%比 3.2%，p=0.01）。再感染发生率为 40.8%（n=182）。总共有 4 例（2.2%）发生 MRSA 转换，占 5.4%。非糖尿病患者的 MRSA 再感染风险是非糖尿病患者的 20.1 倍（28.6%比 1.9%，p<0.001）。MRSA 患者的愈合伤口比例更高（82.4%比 69.3%，p=0.02）。MRSA 与其他感染的再感染在其他临床结局方面无差异（28.6%比 24.3%，p=0.11），包括截肢（48.6%比 52.0%，p=0.69）或住院（28.6%比 42.6%，p=0.11）。首次感染（7.8%）、再感染（6.0%）和转换为 MRSA（2.2%）的 MRSA 发生率较低。无糖尿病的患者中，MRSA 更为常见，发生率为 9.4 倍。
