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Jonathan Mannheim¹, Madan Kumar¹, Palak H Bhagat¹

¹UChicago Medicine Comer Children's Hospital, Chicago, Illinois; and Department of Pediatric Infectious Diseases, University of Chicago, Chicago, Illinois.

Hospital pediatrics

|January 22, 2024

概括

在儿童中,抗甲素黄金葡萄球菌 (MRSA) 查与实际感染的一致性很低,特别是在4天后. 阴性MRSA查不应排除高风险儿童感染.

科学领域:

儿童传染病儿童传染病
临床微生物学临床微生物学
流行病学流行病学

背景情况:

耐甲基西林黄金葡萄球菌 (MRSA) 在儿科医疗机构构成重大威胁.
准确的查对于指导儿童的实证抗MRSA治疗至关重要,特别是那些没有MRSA病史的儿童.
之前的研究表明MRSA查具有很高的实用性,但这些可能并不反映当前的临床现实.

研究的目的:

确定MRSA查在指导确诊MRSA感染儿童的实证抗MRSA治疗中的有用性.
评估MRSA监测屏幕和儿科患者随后感染之间的一致性.
确定影响MRSA查一致性的因素.

主要方法:

在监测屏幕后,对2002年至2022年期间入院的患有MRSA感染的儿科医院患者进行了回顾性分析.
统计分析以确定MRSA查和感染之间的关联.
治疗分析所需的数量,以评估重新查的有用性.

主要成果:

在246名受试者中,MRSA查和感染之间的总体一致性为39.0%.
查灵敏度因感染类型而异:细菌血症为50.0%,呼吸系统为44.4%,皮肤/软组织感染为29.4%.
随着查时间的推移,一致性显著下降,在4天后所有感染均下降到50%以下.

结论:

MRSA查的一致性低于之前报告的,可能是由于患者群体和患病率的差异.
负的MRSA查不应在高风险儿科患者中取代临床怀疑.
随着时间的推移,MRSA查的实用性迅速减少,这表明在某些情况下需要及时重复查.

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