Possible risk for re-colonization with methicillin-resistant Staphylococcus aureus (MRSA) by faecal transmission.
Possible risk for re-colonization with methicillin-resistant Staphylococcus aureus (MRSA) by faecal transmission.
复制标题
可能存在通过粪便传播耐甲氧西林金黄色葡萄球菌 (MRSA) 重新定植的风险。
DOI：
10.1016/j.ijheh.2005.05.004
复制
发表时间：
2005
影响因子：
6
通讯作者：
R. Mutters
中科院分区：
文献类型：
--
作者：
M. Klotz;S. Zimmermann;Sandra Opper;K. Heeg;R. Mutters
耐甲氧西林金黄色葡萄球菌（MRSA）作为医院感染的重要病原体，在世界范围内的频率增加。不幸的是，尽管有最佳的卫生条件（屏障隔离，筛查，去污），患者往往保持MRSA阳性或在再次入院时被检测为“重新定殖”。我们研究的目的是澄清这是否是由于未检测到的胃肠道定植，这可能导致初次成功去污后的再定植。因此，所有的MRSA菌株收集从290名住院患者的大学医院超过2年的时间。令人惊讶的是，从粪便样本中分离出的数量很高（占所有样本的24.1%）。甚至13.1%的总收集可以首先在该材料中观察到，然后在这些患者的其他材料中检测MRSA。为了评估这些菌株的流行病学，脉冲场凝胶电泳（PFGE）。根据PFGE酶切类型，可以鉴定出一个主克隆和11个单克隆。此外，对于6名个体患者，来自粪便标本的MRSA分离株与来自不同位置的其他分离株无法区分。我们在这里表明，MRSA的胃肠道定植显然可以发挥重要作用，通过粪便污染传播MRSA。因此，我们认为MRSA粪便定植可能是迄今为止未被认识到的MRSA在个体患者和人群中传播的来源。因此，我们的研究结果意味着在处理消毒和治疗MRSA患者的卫生策略的修改。
An increase in the frequency of methicillin-resistant Staphylococcus aureus (MRSA) as an important causative agent of nosocomial infections is observed worldwide. Unfortunately, in spite of optimal hygienic conditions (barrier isolation, screening, decontamination), patients often remain MRSA positive or are detected as “re-colonized” at re-admission. The objective of our study was to clarify if this is due to an undetected colonization of the gastrointestinal tract, which could possibly lead to re-colonization after primary successful decontamination. Therefore, all MRSA strains were collected from 290 in-patients of a university hospital over a period of 2 years. A surprisingly high number (24.1% of all) was isolated from stool samples. Even 13.1% of the total collection could be first observed in this material before detecting MRSA in other materials of these patients. To evaluate the epidemiology of these isolates, pulsed-field gel electrophoresis (PFGE) was used. On the basis of PFGE restriction types one main clone and 11 singular clones could be identified. Additionally, for six individual patients MRSA isolates from stool specimens were indistinguishable from other isolates from different locations. We show here that colonization of the gastrointestinal tract with MRSA apparently could play an important role in spreading MRSA via faecal contamination. Hence, we suggest that stool colonization with MRSA could be the source of a so far unrecognized transmission of MRSA within individual patients and within the population. Therefore, our findings imply a modification in the hygienic strategies for handling decontamination and therapy of MRSA patients.