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首页> 外文期刊>Journal of Clinical Microbiology >Trends and Characteristics of Culture-Confirmed Staphylococcus aureus Infections in a Large U.S. Integrated Health Care Organization
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Trends and Characteristics of Culture-Confirmed Staphylococcus aureus Infections in a Large U.S. Integrated Health Care Organization

机译：美国大型综合医疗机构中经培养证实的金黄色葡萄球菌感染的趋势和特征

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Infections due to Staphylococcus aureus present a significant health problem in the United States. Between 1990 and 2005, there was a dramatic increase in community-associated methicillin-resistant S. aureus (MRSA), but recent reports suggest that MRSA may be declining. We retrospectively identified S. aureus isolates (n = 133,450) that were obtained from patients in a large integrated health plan between 1 January 1998 and 31 December 2009. Trends over time in MRSA were analyzed, and demographic risk factors for MRSA versus methicillin-susceptible S. aureus (MSSA) were identified. The percentage of S. aureus isolates that were MRSA increased from 9% to 20% between 1998 and 2001 and from 25% to 49% between 2002 and 2005 and decreased from 49% to 43% between 2006 and 2009. The increase in MRSA was seen in blood and in other bacteriological specimens and occurred in all age and race/ethnicity groups, though it was most pronounced in persons aged 18 to <50 years and African-Americans. Hospital onset infections were the most likely to be MRSA (odds ratio [OR], 1.58; confidence interval [CI], 1.46 to 1.70, compared to community-associated cases), but the largest increase in MRSA was in community-associated infections. Isolates from African-Americans (OR, 1.73; CI, 1.64 to 1.82) and Hispanics (OR, 1.11; CI, 1.06 to 1.16) were more likely to be MRSA than those from whites. After substantial increases between 1998 and 2005 in the proportion of S. aureus isolates that were MRSA, the proportion decreased between 2006 and 2009. Hospital onset S. aureus infections are disproportionately MRSA, as are those among African-Americans.
机译：在美国，由于金黄色葡萄球菌引起的感染存在严重的健康问题。在1990年至2005年之间，与社区相关的耐甲氧西林金黄色葡萄球菌（MRSA）急剧增加，但最近的报道表明MRSA可能正在下降。我们回顾性鉴定了从1998年1月1日至2009年12月31日的大型综合健康计划中的患者获得的金黄色葡萄球菌分离株（ n = 133,450）。分析了MRSA随时间的变化趋势，以及人口统计学风险确定了MRSA与易感甲氧西林金黄色葡萄球菌（MSSA）的相关因素。在1998年至2001年之间，金黄色葡萄球菌分离株的MRSA百分比从9％增加到20％，在2002年至2005年之间从25％增加到49％，在2006年至2009年之间从49％下降到43％。尽管在18至<50岁的人群和非裔美国人中最为明显，但在血液和其他细菌标本中都可见到这种现象，并且在所有年龄段和种族/族裔人群中都存在。医院发作感染最有可能是MRSA（与社区相关病例相比，几率[OR]为1.58;置信区间[CI]为1.46至1.70），但MRSA增幅最大的是社区相关感染。与白人相比，来自非洲裔美国人（OR，1.73; CI，1.64至1.82）和西班牙裔（OR，1.11; CI，1.06至1.16）的分离株更可能是MRSA。在1998年至2005年间，作为MRSA的金黄色葡萄球菌分离物的比例大幅增加之后，在2006年至2009年之间，该比例下降了。医院发作的金黄色葡萄球菌感染与非裔美国人中的MRSA比例不成比例。

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