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在接受急性骨折手术固定的患者中,黄金葡萄球菌的殖民化和手术部位感染
Megan Ahmann1,2, Jocelyn Compton3,4, Jean Pottinger5
1State Hygienic Laboratory at the University of Iowa, Coralville, IA, USA.
甲素耐药黄金葡萄球菌 (MRSA) 的鼻腔携带显著增加了骨折固定手术后手术部位感染 (SSI) 的风险. 许多患者没有接受脱殖治疗,这表明需要改进方案.
科学领域:
- 传染性疾病 传染性疾病
- 整形外科手术 整形外科手术
- 公共卫生 公共卫生
背景情况:
- 金色葡萄球菌的鼻腔携带是手术部位感染 (SSI) 的危险因素.
- 甲素耐药黄金杆菌 (MRSA) 在医疗保健环境中构成重大威胁.
- 有效的去殖民化策略对于预防骨科手术中的SSI至关重要.
研究的目的:
- 为了确定对甲素敏感的金黄色细菌 (MSSA) 和MRSA鼻腔传播的风险因素.
- 为了确定S. aureus鼻携带和骨折固定后的SSI之间的关联.
- 评估S. aureus脱殖的质量改善协议的有效性.
主要方法:
- 对1254名接受骨折固定治疗的成年患者进行回顾性队列研究.
- 查S. aureus鼻腔携带和SSI率的分析.
- 多变量后勤回归用于识别风险因素和关联.
主要成果:
- 鼻腔携带MRSA与SSI (OR4.58),S. aureusSSI (OR10.11) 和MRSASSI (OR27.25) 的风险增加有关.
- 长期护理机构居住是MRSA传播的风险因素 (OR 3.38).
- 携带MSSA并没有与SSI有显著的关联;许多携带者没有接受mupirocin或chlorexidine治疗.
结论:
- 在手术骨折固定后,MRSA鼻腔载体是SSI的重要风险因素.
- 目前的非殖民化协议并不普遍适用,需要简化.
- 有针对性的去殖民化策略对于减少骨科患者SSI至关重要.
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