https://scholars.lib.ntu.edu.tw/handle/123456789/532306
標題: | Nasal carriage of methicillin-resistant Staphylococcus aureus is associated with higher all-cause mortality in hemodialysis patients | 作者: | CHUN-FU LAI Liao C.-H. Pai M.-F. Chu F.-Y. Hsu S.-P. Chen H.-Y. Yang J.-Y. Chiu Y.-L. Peng Y.-S. SHAN-CHWEN CHANG KUAN-YU HUNG TUN-JUN TSAI KWAN-DUN WU |
公開日期: | 2011 | 卷: | 6 | 期: | 1 | 起(迄)頁: | 167-174 | 來源出版物: | Clinical Journal of the American Society of Nephrology | 摘要: | Background and objectives: Methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage is a recognized risk factor for subsequent endogenous infections. However, the association between MRSA carriage and patient survival in hemodialysis patients has not been established. Design, setting, participants, & measurements: In March 2007, this prospective cohort study enrolled 306 out-patients under maintenance hemodialysis from a hospital-based dialysis center in Taiwan. They received two consecutive weekly nasal swab cultures at the beginning of the study. Patients having at least one positive culture of MRSA were defined as MRSA carriers. Subjects were followed up until December 31, 2008. The primary outcome was all-cause mortality. Main secondary outcomes were infection-related mortality and morbidity. Results: We identified 29 MRSA carriers (9.48%) at study entry. After a median of 613 days of follow-up, Kaplan-Meier analysis showed significant survival differences between MRSA carriers and noncarriers (log-rank P = 0.02). Compared with noncarriers, MRSA carriers had a 2.46-fold increased risk of dying from any cause, after adjusting for covariates at the start of follow-up. The adjusted hazard ratios of infection-related mortality and occurrence of subsequent S. aureus infection in carriers were 4.99 and 4.31, respectively. Conclusions: A major limitation is the relatively small sample size of MRSA carriers. Nevertheless, we demonstrated that there may be an association between MRSA nasal carriage and poor clinical outcomes in an outpatient hemodialysis population. This underscores the need for routine surveillance of MRSA nasal carriage and should alert the physicians of a group at high risk of morbidity and mortality. Copyright ? 2011 by the American Society of Nephrology. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-79251520350&doi=10.2215%2fCJN.06270710&partnerID=40&md5=a6b256d1d97dbb6bdf472d6178765fd1 https://scholars.lib.ntu.edu.tw/handle/123456789/532306 |
ISSN: | 1555-9041 | DOI: | 10.2215/CJN.06270710 | SDG/關鍵字: | adult; aged; article; cohort analysis; disease association; female; follow up; hemodialysis; hemodialysis patient; human; major clinical study; male; methicillin resistant Staphylococcus aureus infection; mortality; nose smear; outpatient; prospective study; risk assessment; sample size; Taiwan; Adult; Aged; Aged, 80 and over; Carrier State; Cohort Studies; Female; Humans; Kaplan-Meier Estimate; Male; Methicillin-Resistant Staphylococcus aureus; Middle Aged; Nose; Prospective Studies; Renal Dialysis; Staphylococcal Infections |
顯示於: | 醫學系 |
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