■耐甲氧西林金黄色葡萄球菌(MRSA)肠炎是一种在施用抗菌药物后MRSA在肠道中异常生长的病症,导致肠炎.在粪便培养试验中检测到的MRSA患者通常被诊断为MSRA肠炎。然而,诊断标准仍然存在不确定性;因此,我们进行了流行病学研究来定义这些病例.
■在2012年4月1日至2022年12月31日期间入住高知医学院医院48小时后使用选择性培养基检测MRSA阳性且不符合排除标准的患者纳入研究。我们将MRSA肠炎(A组)定义为对盐酸万古霉素粉治疗有反应的病例,布里斯托尔粪便评分≥5,每天至少3次大便频率;所有其他均为MRSA携带者(B组)。对MRSA肠炎的相关危险因素进行多因素分析。
■A组和B组包括18例(25.4%)和53例(74.6%)患者,分别。多因素logistic回归分析显示白细胞计数>10000/µL(比值比[OR],5.50;95%置信区间[CI],1.12-26.9),粪便培养中MRSA计数≥2+(OR,8.91;95%CI,1.79-44.3),并在粪便标本提交后1个月内给予美罗培南(OR,7.47;95%CI,1.66-33.6)是MRSA肠炎的危险因素。
■对MRSA肠炎的病例定义进行审查可能是有用的诊断标准。
UNASSIGNED: Methicillin-resistant Staphylococcus aureus (MRSA) enteritis is a condition in which MRSA grows abnormally in the intestine after administration of antimicrobial agents, resulting in enteritis. Patients with MRSA detected in stool culture tests are often diagnosed with MSRA enteritis. However, uncertainty remains in the diagnostic criteria; therefore, we conducted epidemiological studies to define these cases.
UNASSIGNED: Patients who tested positive for MRSA by stool culture using selective media 48 h after admission to Kochi Medical School Hospital between April 1, 2012, and December 31, 2022, and did not meet the exclusion criteria were included. We defined MRSA enteritis (Group A) as cases that were responsive to treatment with vancomycin hydrochloride powder, had a Bristol Stool Scale of ≥ 5, and a stool frequency of at least three times per day; all others were MRSA carriers (Group B). Multivariate analysis was performed to risk factors associated with MRSA enteritis.
UNASSIGNED: Groups A and B included 18 (25.4%) and 53 (74.6%) patients, respectively. Multivariate logistic regression analysis showed that a white blood cell count of > 10000/µL (odds ratio [OR], 5.50; 95% confidence interval [CI], 1.12-26.9), MRSA count of ≥ 2+ in stool cultures (OR, 8.91; 95% CI, 1.79-44.3), and meropenem administration within 1 month of stool specimen submission (OR, 7.47; 95% CI, 1.66-33.6) were risk factors of MRSA enteritis.
UNASSIGNED: The case definitions reviewed for MRSA enteritis may be useful as diagnostic criteria.