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呼吸道系メチチリン耐性黄金球菌と,システィック線維症の生存率との関連性
Elliott C Dasenbrook1, William Checkley, Christian A Merlo
1Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Case Western Reserve University School of Medicine and University Hospitals Case Medical Center, Cleveland, Ohio 44106-5067, USA. ecd28@case.edu
JAMA
|June 17, 2010
まとめ
性線維症 (CF) 患者におけるメチシリン耐性黄金球菌 (MRSA) の検出は,死亡率の増加と関連しています. この研究は,M.R.S.A.がCF患者における生存率に及ぼす重大な影響を強調しています.
科学分野:
- 肺内医学 肺内医学 肺内医学
- 感染症 感染症は感染症です.
- 臨床流行病学 臨床流行病学とは
背景:
- 性線維症 (CF) の患者の呼吸道におけるメチシリン耐性黄色のスタフィロコーカス (MRSA) の流行率が増加しています.
- CF患者のアウトカムに対するMRSAの影響に関する不確実性.
- CFにおける感染と死亡率の間の数十年にわたるタイムラインのため,長期的な観察研究が必要である.
研究 の 目的:
- 呼吸器系MRSA隔離とCF患者における生存率との関連性を調査する.
- MRSA検出と検出のないCF患者の生存率を比較する.
- CF集団における死亡リスクに対するMRSAの影響を定量化するために.
主な方法:
- 米国認定センターの6~45歳のCF患者19,833人を対象としたコホート研究.
- 1996年1月から2006年12月までの期間で患者データを収集し,2008年12月まで追跡調査を行った.
- 時間変動の共変数を持つコックス回帰モデルが,生存データを分析するために使用されました.
主要な成果:
- 137,819人の患者年において,MRSAは5,759人の患者で検出され,CF患者は2,537人が死亡しました.
- 死亡率は,MRSA患者 (27.7/1000患者年) の患者 (18.3/1000患者年) の患者と比較して高かった.
- MRSAは独立して死亡リスクの27%増加と関連していました (調整された危険比率,1.27;95%CI,1.11-1.45).
結論:
- CF患者の呼吸道におけるMRSAの検出は,生存率の低下と有意に関連しています.
- MRSAは, cystic fibrosisを有する個体における死亡リスクの増加に寄与します.
- これらの発見は,CFケアにおけるMRSAのモニタリングと管理の重要性を強調しています.
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