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呼吸道甲素耐药黄金葡萄球菌与囊性纤维化症的存活率之间的关联
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
概括
在囊性纤维化 (CF) 患者中检测出甲素耐药黄金葡萄球菌 (MRSA) 与增加的死亡率有关. 这项研究强调了MRSA对CF患者生存率的重大影响.
科学领域:
- 肺部医学 肺部医学
- 传染性疾病 传染性疾病
- 临床流行病学临床流行病学
背景情况:
- 在囊性纤维化 (CF) 患者的呼吸道中,甲素耐药黄金葡萄球菌 (MRSA) 的患病率增加.
- 关于MRSA对CF患者结局的影响的不确定性.
- 长期观察性研究的需要是由于CF感染和死亡率之间的几十年时间表.
研究的目的:
- 研究呼吸道MRSA隔离与CF患者的存活率之间的关联.
- 为了比较CF患者的存活率,有或没有MRSA检测.
- 量化MRSA对CF患者死亡风险的影响.
主要方法:
- 一项队列研究涉及19833名CF患者,年龄在6-45岁,在美国认可的中心.
- 在1996年1月至2006年12月期间收集的患者数据,随访时间至2008年12月.
- 使用可克斯回归模型与时间变化的共变量来分析生存数据.
主要成果:
- 在137,819个患者年中,MRSA在5,759名患者中被检测到,而2,537名CF患者死亡.
- 患有MRSA的患者 (27.7/1000患者年) 的死亡率高于没有 (18.3/1000患者年) 的患者.
- MRSA独立地与27%的死亡风险增加有关 (调整后的危险比,1.27;95% CI,1.11-1.45).
结论:
- 在CF患者的呼吸道中检测到MRSA显著与生存率较差有关.
- 在患有囊性纤维化的人中,MRSA有助于增加死亡风险.
- 这些发现强调了在CF护理中监测和管理MRSA的重要性.
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