社区获得性MRSA感染与定植的危险因素分析

Risk Factors for Infection and Colonization of Community-acquired MRSA

目的评价社区获得性耐甲氧西林金黄色葡萄球菌(MRSA)感染与定植的危险因素。方法对满足条件的12篇有关社区获得性MRSA感染与定植危险因素的随机对照试验进行荟萃分析,并计算每个因素的综合OR值。结果共对8个因素进行评价,分别为近期住院史(OR=2.46,CI为1.25～4.85)、近期抗菌药物使用(OR=2.77,CI为1.34～5.74)、长期入住健康护理院及与医务人员接触(OR=6.48,CI为2.38～17.63)、近期有手术或侵入性操作(OR=2.53,CI为1.90～3.36)、年龄(OR=-1.99,CI为-9.21～5.23)、性别(OR=1.04,CI为0.71～1.51)、吸毒(OR=1.49,CI为0.34～6.54)、基础疾病(OR=1.12,CI为0.55～2.28)。结论近期住院史、抗菌药物使用、长期入住健康护理院及与医务人员接触、近期有手术或侵入性操作是社区获得性MRSA感染与定植的危险因素;而年龄、性别、吸毒、基础疾病等与社区获得性MRSA感染与定植无显著相关。

OBJECTIVE To comprehensively analyze the risk factors for infection and colonization of communityacquired MRSA. METHODS The results of 12 studies were analyzed by meta-analysis and the OR value of every factor was calculated. RESULTS All eight risk factors were evaluated： prior hospitalization （OR = 2. 46, CI 1.25-4.85）, antibiotics exposure recently （OR = 2.77, CI1.34-5.74）, contact with healthcare system and medical workers frequently （OR=6.48, CI2.38-17.63）, surgery or invasive procedure （OR=2.53,CI 1.90-3.36）, age （OR=- 1. 99,CI- 9. 21-5. 23）, gender（OR= 1. 04,CI0. 71-1. 51）, intravenous drug use （OR= 1. 49,CI O. 34-6.54）, and underlying diseases （OR= 1.12,CI0. 55-2.28）. CONCLUSIONS Prior hospitalization, antibiotics exposure recently, contact with healthcare system and medical workers frequently and surgery or invasive procedure are risk factors of community-acquired MRSA. The effects of age, gender, intravenous drug use and underlying diseases need further investigation.