带着这个问题我去查阅了相关文献,发现了再今年AAC上,有作者发表了类似的研究成果。
Staphylococcus aureus Mupirocin and Chlorhexidine Resistance in Patients with Community-Onset Skin and Soft Tissue Infections
Stephanie A. Fritz, MD, MSCI1; Patrick G. Hogan, MPH1; Bernard C. Camins, MD,
7 MSCR2; Ali J. Ainsworth, BS1; Carol Patrick1; Madeline S. Martin, RN, BSN1; Melissa J.
8 Krauss, MPH3; Marcela Rodriguez, MD1†; and Carey-Ann D. Burnham, PhD1,4#
摘要
24 Decolonization measures, including mupirocin and chlorhexidine, are often prescribed
25 to prevent Staphylococcus aureus skin and soft tissue infections (SSTI). The objective
26 of this study was to determine the prevalence of high-level mupirocin and chlorhexidine
27 resistance in S. aureus strains recovered from patients with SSTI before and after
28 mupirocin and chlorhexidine administration, and to determine whether carriage of a
29 mupirocin- or chlorhexidine-resistant strain at baseline precluded S. aureus eradication.
30 We recruited 1089 patients with community-onset SSTI ± S. aureus colonization. In
31 addition to routine care, 483 patients were enrolled in a decolonization trial: 408
32 received intranasal mupirocin (with or without antimicrobial baths), and 258 performed
33 chlorhexidine body washes. Patients were followed for up to 12 months with repeat
34 colonization cultures. 他们随访了12个月。所有的金葡萄菌都检测莫匹罗星和洗必泰耐药基因。All S. aureus isolates were tested for high-level mupirocin and
35 chlorhexidine resistance. At baseline, 23/1089 (2.1%) patients carried a mupirocin36
resistant S. aureus strain and 10/1089 (0.9%) patients carried chlorhexidine-resistant S.
37 aureus. Of 4 patients prescribed mupirocin who carried a mupirocin-resistant S. aureus
38 strain at baseline, 100% remained colonized at 1 month用药一个月后,莫匹罗星耐药基因携带100%, compared to 44% of the 324
39 patients without mupirocin resistance at baseline (p=0.041). Of 2 patients prescribed
40 chlorhexidine who carried a chlorhexidine-resistant S. aureus strain at baseline, 50%
41 remained colonized at 1 month, compared to 48% of the 209 patients without
42 chlorhexidine resistance at baseline (p=1.0)(洗必泰使用一个月后这种携带不明显。但是这种样本量似乎太小了点). The overall prevalence of mupirocin and
43 chlorhexidine resistance is low in S. aureus isolates recovered from outpatients but
44 eradication efforts were less successful in patients carrying a mupirocin-resistant S.
45 aureus strain at baseline.