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ホームIMICライブラリMMWR抄訳2019年(Vol.68)バイタルサイン:メチシリン耐性およびメチシリン感受・・・

MMWR抄訳

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2019/03/08Vol. 68 / No. 9

MMWR68(9):214-219
Vital Signs: Epidemiology and Recent Trends in Methicillin-Resistant and in Methicillin-Susceptible Staphylococcus aureus Bloodstream Infections — United States

バイタルサイン:メチシリン耐性およびメチシリン感受性黄色ブドウ球菌血流感染症の疫学と最近の動向-アメリカ

2005~2016年のEmerging Infections Programのメチシリン耐性黄色ブドウ球菌(MRSA)集団サーベイランスデータ、2012年~2017年のPremier Health DatabaseおよびCerner Health Facts EHRデータより、院内および市中発症MRSAおよびメチシリン感受性黄色ブドウ球菌(MSSA)の傾向と、黄色ブドウ球菌(S. aureus)血流感染症の全体的な発生率および院内死亡率の分析を行った。2005年~2012年の院内および市中発症MRSA感染症の発症率はそれぞれ74%、40%減少し、院内発症MRSAは2005年~2012年にて17.1%/年と有意に減少し、2013年~2016年は有意な低下は認めず、市中発症MRSAは2005年~2016年にて6.9%/年と有意に減少した。2012年~2017年、447病院のデータ分析では、この期間における院内発症MRSA感染症の発生率は7.3%/年減少したが、市中発症MRSAに有意な変動は認めなかった。また、院内発症MSSAに有意な変動はなく、市中発症MSSAは有意に増加した(3.9%/年)。試験期間中のS. aureus感染症による病院での全体死亡率は18%増加したが、2012年~2017年に有意な変動はなく、院内発症MRSAおよびMSSAによる死亡率(29%、24%)は、市中発症MRSAおよびMSSAによる死亡率(18%、14%)に比べ有意に高かった。また、2017年のS.aureus血流感染症は119,247例にて発生し、19,832例が死亡した。2005年以降、MRSA血流感染症の罹患率は減少しているが、S. aureus感染症はアメリカにおける重大な疾病率と死亡率の一因であり、これらの感染症の罹患率をさらに減少するため、医療施設は装置および手順による感染症の予防、伝染阻止のためのCDC勧告を完全に実施するための措置を講じるべきであり、新たな新規予防戦略も必要である。

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