甲素耐药黄金葡萄球菌 (MRSA) 鼻抽样查可靠性,用于预测MRSA烧伤感染
Max L Silverstein1,2, Yvonne Karanas1,2, Clifford C Sheckter1,2
1Regional Burn Center, Santa Clara Valley Medical Center, San Jose, CA, United States.
概括
甲素耐药黄金葡萄球菌 (MRSA) 鼻可以预测烧伤培养结果. 一个阴性鼻断片强烈表明烧伤感染不是由MRSA引起的,允许缓解抗生素治疗的升级.
科学领域:
- 传染性疾病 传染性疾病
- 烧伤护理 烧伤护理
- 微生物学 微生物学
背景情况:
- 感染是烧伤患者死亡的主要原因,软组织感染是败血症的重要来源.
- 甲基西林耐药黄金葡萄球菌 (MRSA) 在烧伤单位中普遍存在,往往需要经验性万科米辛治疗.
- 查MRSA殖民化的鼻子拭子有助于感染控制和消毒策略.
研究的目的:
- 评估MRSA鼻抽样查在预测MRSA在烧伤培养中的存在方面的有用性.
- 为了确定感染烧伤的MRSA鼻子拭子的诊断准确度.
主要方法:
- 250名烧伤患者的回顾性审查,每周接受MRSA鼻抽样查,并在36个月内发展出感染.
- 鼻的结果与来自受感染烧伤的细菌培养的比较.
- 测试性能指标的计算:灵敏度,特异性,正预测值 (PPV) 和负预测值 (NPV).
主要成果:
- 在MRSA鼻子抹布中,敏感度为64.1%,特异性为96.2%,PPV为75.8%,NPV为93.5%.
- 鼻在预测社区获得的MRSA感染 (66.7%阳性) 方面比医院获得的感染 (55.6%阳性) 更敏感.
- 阴性鼻检查结果表明MRSA引起的烧伤感染的可能性很低.
结论:
- 查MRSA鼻片是一种有价值的工具,用于预测烧伤感染中的MRSA.
- 这种高的NPV支持降低MRSA抗生素覆盖率,在那些鼻检查结果为阴性的患者中.
- 应在烧伤中心实施通用MRSA鼻腔查,以指导抗微生物治疗决策.
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