An outbreak of severe infectious diseases caused by methicillin-resistant Staphylococcus aureus USA300 clone among hospitalized patients and nursing staff in a tertiary care university hospital
An outbreak of severe infectious diseases caused by methicillin-resistant Staphylococcus aureus USA300 clone among hospitalized patients and nursing staff in a tertiary care university hospital
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DOI：
10.1016/j.jiac.2019.07.009
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发表时间：
2020-01-01
影响因子：
2.2
通讯作者：
Matsumoto, Tetsuya
中科院分区：
文献类型：
--
作者：
Kobayashi, Takehito;Nakaminami, Hidemasa;Matsumoto, Tetsuya
产生Panton-Valentine杀白细胞素（PVL）的USA 300克隆是一种主要的高致病性社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）克隆，正在世界各地传播。尽管10年前USA 300克隆在日本的流行率非常有限，但近年来其在社区和医院环境中的发病率一直在增加。人们非常担心USA 300克隆将导致更复杂的疾病，并成为医院环境中免疫功能低下患者的严重威胁。在这里，我们报告了一个严重的传染病爆发的三级保健大学医院涉及的发病率的深部感染，包括菌血症，并连续和频繁的MRSA菌株的分离，从6名患者和一名健康的护理人员在同一病房五个月。所有MRSA分离株的基因型与USA 300克隆的基因型相同。此外，脉冲场凝胶电泳分析表明，所有MRSA具有相同的模式。这些数据表明，USA 300克隆爆发发生在医院。幸运的是，在感染控制小组的干预下，这一爆发被终止，所有患者在适当的治疗后康复。我们的报告表明，携带高致病性CA-MRSA的患者有可能成为医院爆发的来源，并可能传播给健康的医护人员。因此，应在入院时对所有患者采取更严格的标准预防措施，以防止此类院内爆发。(C)2019年日本化疗学会和日本传染病协会。由爱思唯尔有限公司出版。保留所有权利。
The USA300 clone, which produces Panton-Valentine leukocidin (PVL), is a major highly pathogenic community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) clone that is spreading throughout the world. Although the prevalence of the USA300 clone in Japan was very limited a decade ago, its incidence has been increasing in both community and hospital settings in recent years. There is great concern that the USA300 clone will cause more complicated diseases and become a serious threat to immunocompromised patients in hospital settings. Here, we report an outbreak of severe infectious diseases in a tertiary care university hospital involving the incidence of deep infections, including bacteremia, and continuous and frequent isolation of MRSA strains for five months from six patients and a healthy nursing staff member in the same ward. The genotype of all MRSA isolates was identical to that of the USA300 clone. Furthermore, pulsed-field gel electrophoresis analysis indicated that all MRSA had the same patterns. These data demonstrate that a USA300 clone outbreak had occurred in the hospital. Fortunately, this outbreak was terminated subsequent to the interventions of the infection control team and all patients recovered following the appropriate therapies. Our report demonstrates that patients carrying highly pathogenic CA-MRSA have the potential to become a source of nosocomial outbreaks that can spread to healthy healthcare workers. Therefore, stricter standard precautions should be applied for all patients at the time of admission to prevent such nosocomial outbreaks. (C) 2019 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.