Methicillin-Resistant Staphylococcus aureus Nasal Colonization among Adult Patients Visiting Emergency Department in a Medical Center in Taiwan 英文参考文献.docVIP

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Methicillin-Resistant Staphylococcus aureus Nasal Colonization among Adult Patients Visiting Emergency Department in a Medical Center in Taiwan 英文参考文献.doc

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Methicillin-Resistant Staphylococcus aureus Nasal Colonization among Adult Patients Visiting Emergency Department in a Medical Center in Taiwan 英文参考文献

Methicillin-ResistantStaphylococcusaureusNasal ColonizationamongAdultPatientsVisitingEmergency DepartmentinaMedicalCenterinTaiwan Sheng-YunLu1.,Fang-YuChang1.,Ching-ChungCheng1,Keong-DiongLee2,Yhu-CheringHuang1,3* 1CollegeofMedicine,ChangGungUniversity,Kweishan,Taoyuan,Taiwan,2DepartmentofEmergencyMedicine,ChangGungMemorialHospitalatLinko,Kweishan, Taoyuan,Taiwan,3DepartmentofPediatrics,ChangGungMemorialHospitalatLinko,Kweishan,Taoyuan,Taiwan Abstract Background: Within the past 10 years, methicillin-resistant Staphylococcus aureus (MRSA) has not only been a hospital pathogenbutalsoacommunitypathogen.Tounderstandthecarriagerateofmethicillin-resistantStaphylococcusaureus (MRSA)amongtheadultpatientsvisitingemergencydepartment(ED),weconductedthisstudy. Methodology/Principal Findings: From May 21 to August 12, 2009, a total of 502 adult patients visiting emergency department(ED)ofatertiarycarehospitalinnorthernTaiwanwererecruitedinthisstudyandsurveyedfornasalcarriageof MRSA.AquestionnaireregardingtheriskfactorsforMRSAacquisitionwasalsoobtained. TheoverallprevalenceofMRSA nasalcarriageamongthepatientswas3.8%.ThecarriageratewassignificantlyhigherinpatientswithriskfactorsforMRSA acquisition (5.94%) than those without risk factors (2.12%). Patients with urinary complaints, diabetes mellitus, chronic kidney disease and current percutaneous tube usage were significantly associated with MRSA colonization. By multiple logistic regression analysis, only current usage of catheters or tubes was the independent predictor for MRSA nasal colonization.Ofthe19MRSA,mostisolatesbelongedtooneoftwolinages,characterizedassequencetype(ST)239(32%) and ST 59 (58%). The latter linage, accounting for 83% of 6 isolates from patients without risk factors, is a community- associated(CA)cloneinTaiwan,whiletheformerlinageisamonghealthcare-associatedclones. Conclusion/Significance:AsubstantialproportionofpatientsvisitingED,particularlywithcurrentusageofpercutaneous catheterortubes,innorthernTa