Buck Jessica M, Como-Sabetti Kathryn, Harriman Kathleen H, Danila Richard N, Boxrud David J, Glennen Anita, Lynfield Ruth
Minnesota Department of Health, Minneapolis, Minnesota, USA.
Emerg Infect Dis. 2005 Oct;11(10):1532-8. doi: 10.3201/eid1110.050141.
We compared characteristics of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft tissue infections (SSTIs) and CA-MRSA invasive disease identified in Minnesota from 2000 through 2003. A total of 586 patients with SSTIs and 65 patients with invasive disease were identified. Patients with invasive disease were more likely to be smokers (p = 0.03), and report a history of immunosuppressive therapy (p = 0.03), emphysema (p = 0.011), or injection drug use (p = 0.020) than were SSTI patients. Invasive disease isolates were less likely to be susceptible to ciprofloxacin (p = 0.002) and clindamycin (p = 0.001) and more likely to have healthcare-associated pulsed-field gel electrophoresis subtypes than SSTI isolates (p<0.001). Patients with invasive disease may have had healthcare exposures that put them at risk of acquiring healthcare-associated MRSA and which were not exclusion criteria in the CA-MRSA case definition. Continued surveillance of MRSA is needed to better characterize CA-MRSA infections.
我们比较了2000年至2003年在明尼苏达州发现的社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)皮肤及软组织感染(SSTIs)和CA-MRSA侵袭性疾病的特征。共识别出586例SSTIs患者和65例侵袭性疾病患者。与SSTIs患者相比,侵袭性疾病患者更有可能是吸烟者(p = 0.03),且有免疫抑制治疗史(p = 0.03)、肺气肿(p = 0.011)或注射吸毒史(p = 0.020)。侵袭性疾病分离株对环丙沙星(p = 0.002)和克林霉素(p = 0.001)的敏感性较低,且与SSTIs分离株相比,更有可能具有与医疗保健相关的脉冲场凝胶电泳亚型(p<0.001)。侵袭性疾病患者可能有医疗保健接触史,这使他们有感染医疗保健相关MRSA的风险,而这在CA-MRSA病例定义中并非排除标准。需要持续监测MRSA,以更好地描述CA-MRSA感染的特征。