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首页> 外文期刊>Journal of Clinical Microbiology >Predominance of Methicillin-Resistant Staphylococcus aureus among Pathogens Causing Skin and Soft Tissue Infections in a Large Urban Jail: Risk Factors and Recurrence Rates
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Predominance of Methicillin-Resistant Staphylococcus aureus among Pathogens Causing Skin and Soft Tissue Infections in a Large Urban Jail: Risk Factors and Recurrence Rates

机译：在大型城市监狱中，导致皮肤和软组织感染的病原体中耐甲氧西林金黄色葡萄球菌的优势：危险因素和复发率

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In the 1990s, community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strains emerged as pathogens outside of the health care environment. Epidemic foci of CA-MRSA infections were reported in jails and prisons, but risk factors for MRSA infection there are not known. All skin and soft tissue infections (SSTIs) cultured in the Cook County Jail in March 2004 to August 2005 were reviewed. Demographic and clinical risk factors were compared among patients with methicillin-susceptible S. aureus (MSSA) SSTIs and those with MRSA SSTIs. Antibiotic susceptibilities were recorded, and we performed multilocus sequence typing on a sample of MRSA isolates. There were 378 SSTIs from different patients requiring culture, of which 240 (63.5%) were of MRSA and 43 (11.4%) were of MSSA; 84.8% of S. aureus isolates were MRSA. MRSA- and MSSA-infected patients were similar with regard to age, gender, ethnicity, previous exposure to the jail, and comorbidities. In the 12 months prior to the index culture, MRSA patients were more likely to have received a β-lactam antibiotic (25% versus 9%; P = 0.02). Among 26 MRSA strains, 24 (92%) had the sequence type 8 (ST8) genotype. Within 6 months, 14% (95% confidence interval, 8.7% to 22.3%) of MRSA SSTI patients in the jail had a recurrent SSTI compared with 8.8% (95% confidence interval, 2.1% to 32.6%) of MSSA SSTI patients (P = 0.004). MRSA is the predominant cause of SSTIs requiring culture in the jail. Few risk factors differentiated MRSA from MSSA SSTIs, and detainee patients with MRSA SSTIs are at high risk for recurrent SSTIs.
机译：在1990年代，社区相关耐甲氧西林的金黄色葡萄球菌（CA-MRSA）菌株作为病原体出现在医疗保健环境之外。据报道在监狱和监狱中发生了CA-MRSA感染的流行病灶，但尚不知道发生MRSA感染的危险因素。回顾了2004年3月至2005年8月在库克县监狱培养的所有皮肤和软组织感染（SSTI）。比较了对甲氧西林敏感的 S患者的人口统计学和临床​​危险因素。金黄色葡萄球菌（MSSA）SSTI和具有MRSA SSTI的SSTI。记录了抗生素敏感性，我们对MRSA分离物样品进行了多基因座序列分型。不同患者需要培养的378个SSTI，其中MRSA占240个（63.5％），MSSA占43个（11.4％）。 S的84.8％。金黄色葡萄球菌是MRSA。 MRSA和MSSA感染的患者在年龄，性别，种族，先前入狱和合并症方面相似。在索引培养之前的12个月中，MRSA患者更有可能接受β-内酰胺类抗生素（25％比9％; P = 0.02）。在26个MRSA菌株中，有24个（92％）具有序列类型8（ST8）基因型。在六个月内，监狱中有14％（95％置信区间，8.7％至22.3％）的MRSA SSTI患者患有复发性SSTI，而MSSA SSTI患者则为8.8％（95％置信区间，2.1％至32.6％）（ P = 0.004）。 MRSA是需要在监狱中进行培养的SSTI的主要原因。很少有将MRSA与MSSA SSTI区别开的危险因素，并且患有MRSA SSTI的被拘留者患者复发SSTI的风险很高。

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