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首页> 外文期刊>Zoonoses and Public Health >Risk of hospitalization and death within 2 years after methicillin-resistantStaphylococcus aureus(MRSA) diagnosis in persons colonized or infected with livestock and non-livestock-associated MRSA-A nationwide register-based cohort study
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Risk of hospitalization and death within 2 years after methicillin-resistantStaphylococcus aureus(MRSA) diagnosis in persons colonized or infected with livestock and non-livestock-associated MRSA-A nationwide register-based cohort study

机译：2年后甲氧西林 - 抵抗力后2岁内的住院和死亡风险（MRSA）诊断殖民或感染牲畜和非牲畜相关的MRSA-A全国基于寄存器的队列的群组研究

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Livestock-associated methicillin-resistantStaphylococcus aureus(LA-MRSA) CC398 has emerged in humans throughout Europe and the USA during the last decade and is associated with the spread of LA-MRSA CC398 in production animals. In this study, we investigated the risk of subsequent hospitalization with anS. aureus-related diagnosis and death within the first 2 years after MRSA diagnosis. The study included 7,521 carriers of MRSA, an age-matched reference population of 376,041 individuals and 7,607 patients infected with MRSA. Hazard ratios (HR) for hospitalization with anS. aureus-related diagnosis were 4.09 (95% CI: 2.78-6.00) and for death 1.21 (95% CI: 0.80-1.83) in LA-MRSA CC398 carriers compared with the reference population. Comparing carriers of LA-MRSA CC398 and non-CC398 MRSA, HR for hospitalization was 0.61 (95% CI: 0.37-0.99) and death 0.25 (95% CI: 0.16-0.40), respectively. Patients initially diagnosed with LA-MRSA CC398 or non-CC398 MRSA infection differed from MRSA carriers in terms of older age, higher Charlson comorbidity index score and longer hospital stays. HR for subsequent hospitalization and death was similar regardless having infection with LA-MRSA CC398 or non-CC398 MRSA at the time of MRSA diagnosis. We established that MRSA CC398 carriers have a lower risk of hospitalization and death up to 2 years after MRSA diagnosis than non-CC398 MRSA carriers do. In contrast, MRSA carriage, regardless the MRSA strain is a burden in terms of hospitalization and death when compared to the background reference population. Further, we established that there are no differences in risk of subsequent hospitalization and death in patients initially diagnosed with MRSA CC398 or non-CC398 MRSA infection. We suggest that public health surveillance of MRSA clearly needs to distinguish between carriage and infection as well as strain type before any inference from number of cases to disease burden is made.
机译：在过去十年中，牲畜相关的甲硝素抗性滑雪膜AUREUS（LA-MRSA）CC398已在欧洲和美国出现在欧洲和美国。与La-MRSA CC398在生产动物中的传播有关。在这项研究中，我们调查了随后与ANS住院治疗的风险。在MRSA诊断后的前两年内金黄色葡萄球菌相关的诊断和死亡。该研究包括MRSA的7,521个载体，年龄匹配的参考人口376,041名，7,607名患者感染MRSA。危险比率（HR）与ANS住院治疗。与参考人口相比，金黄色葡萄球菌相关诊断为4.09（95％CI：2.78-6.00）和La-MRSA CC398载体的死亡1.21（95％CI：0.8-1.83）。 La-MRSA CC398和非CC398 MRSA的载体，HR用于住院治疗为0.61（95％CI：0.37-0.99）和死亡0.25（95％CI：0.16-0.40）。最初被诊断出患有La-MRSA CC398或非CC398 MRSA感染的患者与MRSA运营商在年龄较大的较大年龄方面不同，Charlson合并症指数得分和较长的医院住宿。由于在MRSA诊断时具有La-MRSA CC398或非CC398 MRSA的感染，HR用于随后的住院和死亡。我们建立了MRSA CC398载体在MRSA诊断后2年的住院和死亡风险较低，而不是非CC398 MRSA载体。相比之下，与背景参考人口相比，MRSA托运无论MRSA菌株都是在住院和死亡方面的负担。此外，我们确定最初诊断患有MRSA CC398或非CC398 MRSA感染的患者随后的住院和死亡风险没有差异。我们建议对MRSA的公共卫生监测显然需要区分托运和感染以及在从疾病负担的案件数量的任何推论之前进行托运和感染以及菌株类型。

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