アメリカ合衆国におけるメチシリン耐性である侵襲的な黄金球菌感染
R Monina Klevens1, Melissa A Morrison, Joelle Nadle
1Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. rmk2@cdc.gov
JAMA
|October 18, 2007
まとめ
浸透性メチチリン耐性黄金球菌 (MRSA) 感染症は,高齢者,黒人,男性に不釣り合いな影響を及ぼし,重大な公衆衛生上の懸念となっています. これらの感染症は主にヘルスケアに関連していますが,伝統的な病院環境の外でますます多く見られます.
科学分野:
- 感染症 感染症は感染症です.
- エピデミオロジー エピデミオロジー
- 公衆衛生は公衆衛生である.
背景:
- 米国におけるメチチリン耐性黄金球菌 (MRSA) 感染の範囲に関する正確なデータは,流行病学が進化しているため,極めて重要です.
- 侵入性MRSAの負担を理解することは,公衆衛生戦略にとって不可欠です.
研究 の 目的:
- 侵襲的なMRSA疾患の発生率と分布を米国の9つのコミュニティで決定する.
- 2005年の米国における侵入性MRSA感染の総負担を推定する.
主な方法:
- 2004年7月から2005年12月までの間,侵襲性MRSAの集団ベースのサーベイランスは,米国の9カ所で実施されました.
- MRSA症例は調査され,ヘルスケア関連 (病院発症またはコミュニティ発症) またはコミュニティ関連として分類されました.
- MRSA菌株の発生率,死亡率,分子特徴を分析した.
主要な成果:
- 合計8987件の侵入性MRSA症例が報告されました. 大半は医療関連 (85%) で,58.4%はコミュニティでの発症,26.6%は病院での発症でした.
- 2005年の侵入性MRSAの標準化発生率は,人口10万人に31.8人でした.
- 発症率は65歳以上,黒人,男性で最高でした. 標準化された死亡率は10万人に6.3であった.
結論:
- 侵襲的なMRSA感染は,特定の集団に不釣り合いな影響を及ぼし,健康格差を強調しています.
- MRSAは依然として主要な公衆衛生問題であり,主に医療環境に関連していますが,従来の限界を超えて広がっています.
- 分子分析により,すべての監視領域におけるヘルスケア関連感染症におけるコミュニティ関連MRSA菌株の存在が明らかになった.
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