Significance of airborne transmission of methicillin-resistant Staphylococcus aureus in an otolaryngology-head and neck surgery unit
Significance of airborne transmission of methicillin-resistant Staphylococcus aureus in an otolaryngology-head and neck surgery unit
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DOI：
10.1001/archotol.127.6.644
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发表时间：
2001-06-01
影响因子：
--
通讯作者：
Makishima, K
中科院分区：
文献类型：
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作者：
Shiomori, T;Miyamoto, H;Makishima, K
目的：定量调查医院环境中空气中甲氧西林耐药金黄色葡萄球菌(MRSA)的存在，并对MRSA分离株进行表型和基因分型，以研究MRSA的流行病学。设计：对MRSA感染或定植的患者进行前瞻性监测，同时对环境空气进行观察性研究。空气样品由空气采样器采集，样品通过盖章或拭子从物体表面获得。采用药敏试验、凝固酶分型和脉冲凝胶电泳法对MRSA分离株进行流行病学研究。地点：耳鼻咽喉头颈外科37张病床的3个单病室。患者：观察到3例头颈部鳞状细胞癌患者在手术后定植或感染MRSA。结果：MRSA样本采集于单病室休息期间和更换床单时。在所有阶段(从阶段1[>；7 PM]到阶段6[0.65-1.1um])都检测到了MRSA分离株。大约20%的MRSA颗粒在小于4微米的可呼吸范围内。耐甲氧西林S金黄色葡萄球菌也从无生命环境中分离出来，如水槽、地板和床单，从MRSA感染患者的房间和患者的手中分离到。流行病学研究表明，本病房临床分离的耐甲氧西林金黄色葡萄球菌来源单一，空气和无生命环境中分离的菌株与引起住院患者感染或定植的耐甲氧西林金黄色葡萄球菌一致。结论：耐甲氧西林S金黄色葡萄球菌在患者、空气和室内环境中循环，尤其是在室内有活动的情况下。气载MRSA可能在MRSA鼻腔定植或呼吸道MRSA感染中起一定作用。应采取措施防止空气中MRSA的传播，以控制医院内的MRSA感染。
Objectives: lo quantitatively investigate the existence of airborne methicillin-resistant Staphylococcus aureus (MRSA) in a hospital environment and to perform phenotyping and genotyping of MRSA isolates to study MRSA epidemiology.Design: Prospective surveillance of patients with MRSA infections or colonizations was performed, as was an observational study of environmental air. Airborne samples were taken by an air sampler, samples were obtained from object surfaces by stamping or swabbing. Epidemiological study of MRSA isolates was performed with an antibiotic susceptibility test, coagulase typing, and pulsed-held gel electrophoresis.Setting: Three single-patient rooms in a 37-bed otolaryngology-head and neck surgery unit.Patients: Three patients with squamous cell head and neck cancer were observed to have been colonized or infected with MRSA after surgery.Results: The MRSA samples were collected from the air in single-patient rooms during both a period of rest and when bedsheets were being changed. Isolates of MRSA were detected in all stages (from stage 1 [>7 pm] to stage 6 [0.65-1.1 mum]). About 20% of the MRSA particles were within a respirable range of less than 4 mum. Methicillin-resistant S aureus was also isolated from inanimate environments, such as sinks, floors, and bedsheets, in the rooms of the patients with MRSA infections as well as from the patients' hands. An epidemiological study demonstrated that clinical isolates of MRSA in our ward were of one origin and that the isolates from the air and from inanimate environments were identical to the MRSA strains that caused infection or colonization in the inpatients.Conclusions: Methicillin-resistant S aureus was recirculated among the patients, the air, and the inamimate environments, especially when there was movement in the rooms. Airborne MRSA may play a role in MRSA colonization in the nasal cavity or in respiratory tract MRSA infections. Measures should be taken to prevent the spread of airborne MRSA to control nosocomial MRSA infection in hospitals.