An outbreak of a Multiresistant Methicillin-Susceptible Staphylococcus aureus (MR-MSSA) strain in a Burn Centre: The importance of routine molecular typing
An outbreak of a Multiresistant Methicillin-Susceptible Staphylococcus aureus (MR-MSSA) strain in a Burn Centre: The importance of routine molecular typing
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DOI：
10.1016/j.burns.2011.01.005
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发表时间：
2011-08-01
期刊：
影响因子：
2.7
通讯作者：
Diederen, B. M. W.
中科院分区：
文献类型：
--
作者：
Boers, S. A.;van Ess, I.;Diederen, B. M. W.
在这里，我们报告了一个烧伤中心的多重耐甲氧西林敏感金黄色葡萄球菌（MR-MSSA）的单一菌株引起的17名患者的爆发。MR-MSSA菌株对青霉素、环丙沙星、红霉素、克林霉素和复方新诺明耐药。进一步分析显示，在S.金黄色葡萄球菌定植于烧伤中心的患者，从2005年的0%（0/118）、2006年的3.3%（4/121）、2007年的6.1%（6/99）到2008年的7.8%（7/90）。扩增片段长度多态性的分子分型表明，所有来自烧伤中心患者的MR-MSSA分离株具有独特的基因型，并且与来自其他医院患者的分离株相比是不同的。在爆发期间在烧伤中心工作的所有医护人员（HCW）都接受了MR-MSSA鼻携带筛查。一名HCW检测出MR-MSSA基因型阳性，该基因型与烧伤患者样本中发现的基因型无法区分。在被定植的HCW停止在烧伤中心工作后，没有发现新的MR-MSSA定植或感染病例。收集的沙门氏菌分子分型的常规做法。来自患者和医护人员的金黄色葡萄球菌菌株将有助于检测烧伤中心的医院传播，并开启了快速、几乎先发制人的反应的可能性。(C)2011 Elsevier Ltd和ISBI。All rights reserved.
Here we report an outbreak among 17 patients caused by a single strain of a Multiresistant Methicillin-Susceptible Staphylococcus aureus (MR-MSSA) in a burn centre. The MR-MSSA strains were resistant to penicillin, ciprofloxacin, erythromycin, clindamycin and co-trimoxazole. Further analysis showed an increased prevalence of MR-MSSA carriership in S. aureus colonized patients admitted to the burn centre, from 0% in 2005 (0/118), 3.3% in 2006 (4/121), 6.1% in 2007 (6/99), to 7.8% in 2008 (7/90). Molecular typing with Amplified Fragment Length Polymorphism showed that all MR-MSSA isolates derived from burn centre patients had a unique genotype, and was different compared to isolates derived from other hospital patients. All healthcare workers (HCWs) who worked in the burn centre during the outbreak were screened for nasal carriage with MR-MSSA. One HCW tested positive for a genotype of MR-MSSA that was indistinguishable from the genotype found in samples of the burned patients. No new cases of MR-MSSA colonization or infection were identified after the colonized HCW stopped working at the burn centre. The routine practice of molecular typing of collected S. aureus strains from both patients and HCWs will help to detect nosocomial spread in a burn centre, and opens the possibility of a rapid, almost pre-emptive response. (C) 2011 Elsevier Ltd and ISBI. All rights reserved.