Staphylococcus aureus carrying Panton-Valentine leukocidin genes nasal colonization and skin infection: Screening in case of outbreak in a school environment
Staphylococcus aureus carrying Panton-Valentine leukocidin genes nasal colonization and skin infection: Screening in case of outbreak in a school environment
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DOI：
10.1016/j.medmal.2008.06.025
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发表时间：
2008-09-01
影响因子：
5
通讯作者：
Coignard, B.
中科院分区：
文献类型：
--
作者：
Carre, N.;Sillam, F.;Coignard, B.
目标. - 对2006年大巴黎地区一所小学爆发的携带Panton-Valentine杀白细胞素（PVL）基因的金黄色葡萄球菌（SA）皮肤感染进行了调查和监测。- 小学教师、学生及其亲属在学年开始后报告的皮肤感染在当地医院得到诊断和治疗，并进行了鼻腔定植检查。出现毛囊炎、脓肿或疖且SA-PV皮肤试验或鼻拭子阳性的患者被认为是感染病例。定殖定义为在无皮肤病变的情况下在鼻拭子中鉴定出SA-PVL。除了推荐的控制措施外，还为所有定植患者和感染患者的亲属开出了局部鼻内莫匹罗星治疗的处方。结果。- 在五个月内，22例PVL阳性SA皮肤感染。包括一例单纯性毛囊炎，确诊15名小学生（发病率= 18.5%）和7名亲属。根据家庭中皮肤感染病例数，不同学校的亲属中鼻定植的发生率为0 ~ 30%（p < 0.01）。莫匹罗星治疗的患者中有三分之二去殖民化。- 这种SA菌株在学校和家庭环境中的传播证实了PVL阳性分离株的流行潜力，然而，鼻定植筛查应仅限于皮肤感染病例和直接环境中的人群。(C)2008年，Elsevier Masson SAS。吨储备。
Objectives. - An outbreak of Staphylococcus aureus (SA) carrying the gene coding for Panton-Valentine leukocidin (PVL) skin infections in a primary school was investigated and monitored in the Val-d'Oise region (Greater Paris) in 2006.Patients and methods. - Skin infections reported after the beginning of the school year in primary-school teachers, students and their relatives were diagnosed and treated at the local hospital and screening for nasal colonization was implemented. A patient presenting with folliculitis, an abscess or furuncle with a positive-skin test or nasal swab for SA-PV was considered to be a case of infection. Colonization was defined as identification of SA-PVL in a nasal swab in the absence of skin lesions. In addition to recommended control measures, treatment by topical intranasal mupirocin was prescribed to all colonized patients and relatives of infected patients.Results. - Over five months, 22 cases of PVL-positive SA skin infections. including a case of simple folliculitis, were confirmed in 15 primary-school students (attack rate = 18.5%) and seven relatives. The occurrence of nasal colonization in relatives not attending the same school ranged from 0 to 30% according to the number of cases of skin infection in the family (p < 0.01). Two-thirds of patients treated with mupirocin were decolonized.Conclusion. - Transmission of this SA strain in school and family environments confirms the epidemic potential of PVL-positive isolates however, screening for nasal colonization should be restricted to cases of skin infection and people in their immediate environment. (C) 2008 Elsevier Masson SAS. Tons droits reserves.