Should the methicillin-resistant Staphylococcus aureus carriage status be used as a guide to treatment for skin and soft tissue infections?
作者： Alexandra Reber , Andreea Moldovan , Nathalie Dunkel , Stéphane Emonet , Peter Rohner
DOI: 10.1016/J.JINF.2011.12.023
关键词: Staphylococcus aureus 、 Carriage 、 Antibiotics 、 Proportional hazards model 、 Surgery 、 Internal medicine 、 Soft tissue 、 Retrospective cohort study 、 Hazard ratio 、 Medicine 、 Methicillin-resistant Staphylococcus aureus
摘要: Summary Objective Previous skin carriage of methicillin-resistant Staphylococcus aureus (MRSA) leads frequently to empiric antibiotic MRSA coverage for & soft tissue infections. Methods Retrospective cohort study orthopaedic patients hospitalized at Geneva University Hospitals (MRSA prevalence; 30%); community-acquired excluded. Results A total 378 and infections in 346 were retrieved. Overall cure was achieved 330 episodes (87%) after a median administration 15 days. Among all episodes, 102 revealed positive current status (during 2 weeks preceding infection; 27%) 70 (19%) carriers the past. Sensitivity, specificity, negative predictive values predict abscesses due 0.68, 0.77, 0.19, 0.97, respectively. Fifty-four (54/102, 53%) 30 past (43%) successfully treated with non-MRSA agent. In multivariate Cox regression analysis, anti-MRSA (hazard ratio 1.2, 95%CI 0.5–2.8) duration therapy (HR 1.0, 0.96–1.02) did not influence treatment failure among carriage. Conclusions Current or HA-MRSA poorly predicts need patients.
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