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首页> 外文期刊>Journal of Clinical Microbiology >High Staphylococcus aureus Colonization Prevalence among Patients with Skin and Soft Tissue Infections and Controls in an Urban Emergency Department
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High Staphylococcus aureus Colonization Prevalence among Patients with Skin and Soft Tissue Infections and Controls in an Urban Emergency Department

机译：皮肤和软组织感染与控制的城市急诊科患者中金黄色葡萄球菌高定植率

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Staphylococcus aureus is a commensal species that can also be a formidable pathogen. In the United States, an epidemic of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections has been occurring for the last 15 years. In the context of a study in which we identified patients with skin and soft tissue infections (SSTIs) and randomized them to receive one of two antimicrobial treatment regimens, we assessed S. aureus colonization in the nares, throat, and perianal skin on the day of enrollment and 40 days after therapy. We compared the prevalence of colonization between the SSTI patients and an uninfected control population. A total of 144 subjects and 130 controls, predominantly African American, participated in this study, and 116 returned for a 40-day follow-up visit. Of the SSTI patients, 76% were colonized with S. aureus at enrollment, as were 65% of the controls. Patients were more likely than the controls to be colonized with USA300 MRSA (62/144 [43.1%] versus 11/130 [8.5%], respectively; P < 0.001). The nares were not the most common site of colonization. The colonization prevalence diminished somewhat after antibiotic treatment but remained high. The isolates that colonized the controls were more likely than those in the patients to be methicillin-susceptible S. aureus (MSSA) (74/84 [88.1%] versus 56/106 [52.8%], respectively; P < 0.001). In conclusion, the prevalence of S. aureus colonization among SSTI patients was high and often involved USA300 MRSA. The prevalence diminished somewhat with antimicrobial therapy but remained high at the 40-day follow-up visit. Control subjects were also colonized at a high prevalence but most often with a genetic background not associated with a clinical infection in this study. S. aureus is a commensal species and a pathogen. Plans for decolonization or eradication should take this distinction into account.
机译：金黄色葡萄球菌是共生种，也可以是强大的病原体。在美国，过去15年一直在发生由社区获得的耐甲氧西林金黄色葡萄球菌（MRSA）感染的流行病。在一项研究中，我们确定了患有皮肤和软组织感染（SSTI）的患者，并随机将他们接受两种抗菌治疗方案中的一种，我们评估了当天金黄色葡萄球菌在鼻孔，咽喉和肛周皮肤中的定植情况入组和治疗后40天。我们比较了SSTI患者和未感染对照人群之间的定殖率。共有144位受试者和130位对照者（主要为非裔美国人）参加了此研究，其中116位患者返回进行了为期40天的随访。在SSTI患者中，入选时有76％的患者被金黄色葡萄球菌定植，而对照组中则有65％。与对照组相比，患者更有可能被USA300 MRSA定植（分别为62/144 [43.1％]和11/130 [8.5％]; P <0.001）。鼻孔不是最常见的殖民地。抗生素治疗后定植率有所降低，但仍然很高。定居于对照中的分离株比患者中的分离株更有可能是对甲氧西林敏感的金黄色葡萄球菌（MSSA）（分别为74/84 [88.1％]和56/106 [52.8％]; P <0.001）。总之，在SSTI患者中金黄色葡萄球菌定植的患病率很高，并且经常涉及USA300 MRSA。抗菌药物治疗的患病率有所降低，但在40天的随访中仍然很高。在本研究中，对照组也以高患病率定植，但最常见的是遗传背景与临床感染无关。金黄色葡萄球菌是共生物种和病原体。非殖民化或根除计划应考虑到这一区别。

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