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中国大陆手术部位感染患者中两种葡萄球菌感染

Background
Sufficient details have not been specified for the epidemiological characteristics of Staphy- lococcus aureus (S. aureus) and methicillin-resistant Staphylococcus aureus (MRSA)
among surgical site infections (SSls) in mainland China. This systematic reviewaimed to estimate proportions ofS. aureus and MRSAin SSIs through available published studies.
 
Methods
PubMed, Embase and fourChinese electronic databases were searched to identify relevant primary studies published between 2007and 2012. Meta-analysis was conducted on the basis of logit-transformed metric forproportions ofS. aureus and MRSA, followed by pre- defined subgroup meta-analysis. Random-effects meta-regression was also conducted to explore the impact ofpossible factors on S. aureus proportions.
 
Results
106 studies were included, of which 38 studies involved MRSA.S. aureus accounted for 19.1% (95%Cl 17.2-21.0%;1P=84.1%) ofallisolates in SSls, which was roughly parallelto 18.5% in the United States (US) (P-value =0.57) but significantly exceeded those calculated through the surveillance system in China(P-value<0.001).In subgroup analysis, S. aureus in patients with thoracic surgery (41.1%,95%C126.3-57.7%;1P=74.4%) was more common than in those with gynecologic surgery (20.1%, 95%Cl 15.6-25.6%;12=33.0%) orabdominal surgery (13.8%,95%C110.3-18.4%;12=70.0%). Similar results were foundin meta-regression. MRSA accounted for41.3% (95%Cl 36.5-46.3%;1?= 64.6%)ofS. aureus significantly lowerthan thatin the US (P-value=0.001). MRSA was sensitive to vancomycin (522/522) and linezolid (93/94), while 79.9% (95%C1 67.4-88.4%;1P= 0%) and 92.0% (95%Cl 80.2-97.0%;1P=0%) of MRSA was resistantto clindamycin and erythromycin respectively.
 
Conclusion
The overall proportion of S. aureus among SSIs in China was similarto thatin the US but seemed higher than those reported through the Chinese nationalsurveillance system.Pro- portions of S. aureus SSls may vary with differentsurgerytypes. Commonly seen in SSls, MRSA tended to be highly sensitive to vancomycin and linezolid but mostly resistantto clin- damycin and erythromycin.