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McDonald LC. Clin Infect Dis. ;42:S65-S71.
Nosocomial infection
Community-acquired infection
Penicillinase-producing S aureus
0
25
50
75
100
1940
1960
1980
Year
Resistant isolates (%)
Methicillin-resistant S aureus
0
25
50
75
100
1940
1960
1980
Year
Resistant isolates (%)
Progression of resistant Staphylococcus aureus
A similar trend in the increase in nosocomial infections caused by antimicrobial-resistant S aureus isolates can be observed in community-acquired infections
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Emergence of resistant pathogens
Increase in nosocomial S aureus bacteremia predominantly due to the increase in MRSA in the UK
Wyllie D, et al. BMJ. ;333:281-284.
Cohort study in Oxfordshire, UK; MSSA = methicillin-sensitive Staphylococcus aureus
a Per 100,000 admissions; b P< .01; c P > .2.
Year
400
500
300
200
150
100
50
1997
1999
1998
Cases of
S aureus
Bacteremia*
Year
400
500
300
150
100
50
1997
1999
1998
Cases of
S aureus
Bacteremiaa
All Nosocomial S aureus Bacteremia
b
Year
400
500
300
200
150
100
50
1997
1999
1998
Cases of
S aureus
Bacteremia*
Year
400
500
300
200
150
100
50
1997
1999
1998
Cases of
S aureus
Bacteremiaa
MSSA
MRSA
c
b
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HA-MRSA Strains
High local prevalence
History of MRSA infection or colonization
Close contact with infected individual
Extended hospitalization
Resident of nursing home or long-term-care facility
Invasive devices
Dialysis
Catheterization
Enteral feeding
Recent antibiotic use
Risk factors for infection with MRSA
CA-MRSA Strains
High local prevalence
History of MRSA infection or colonization
Close contact with infected individual
Crowded and/or unsanitary conditions
Prison
Military camp
Depressed immune system
Participation in contact sports
Sharing athletic equipment/towels
Intravenous drug abuse
1. MRSA Infection. . Availabe at: =4. 2. Graffunder EM, Venezia RA. J Antimicrob Chemother. ;49:999-1005. 3. Safdar N, Maki DG. Ann Intern Med. ;136:834-844. 4. Moran GJ, et al. N Engl J Med. ;355:666-74.
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MRSA感染危害
MRSA感染可能
增加死亡风险1
增加患病率2,3
延长住院时间2,3
增加住院费用1,2,4
1. Rubin RJ, et al. Emerg Infect Dis. 1999;5:9-17.
2. Carbon C. J Antimicrob Chemother. 1999;44(suppl A):31-36.
3. The Brooklyn Antibiotic Resistance Task Force. Infect Control Hosp Epidemiol. ;23:106-108.
4. Abramson MA et al. Infect Control Hosp Epidemiol. 1999;20:408-411.
5. Cosgrove SE et al. Clin Infect Dis. ;36:53-59.
死亡率相关性比较5： MRSA vs MSSA
比值比
研究
MSSA:methicillin-sensitive staphylococcus aureus
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