Nosocomial antibiotic-associated diarrhea associated with enterotoxin-producing strains of methicillin-resistant Staphylococcus aureus
Nosocomial antibiotic-associated diarrhea associated with enterotoxin-producing strains of methicillin-resistant Staphylococcus aureus
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DOI：
10.1111/j.1572-0241.2005.41510.x
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发表时间：
2005-08-01
影响因子：
9.8
通讯作者：
Havill, NL
中科院分区：
文献类型：
--
作者：
Boyce, JM;Havill, NL
目的：本研究的目的是提出新的证据表明，耐甲氧西林金黄色葡萄球菌肠毒素生产菌株可能会导致医院内腹泻相关diarrheumato.METHODS：我们进行了一项前瞻性研究，利用标准方法排除其他细菌，寄生虫和病毒病原体作为医院内腹泻的原因与耐甲氧西林金黄色葡萄球菌大量生长的患者。金黄色葡萄球菌在他们的粪便。对S.金黄色葡萄球菌菌株从患者的粪便和受影响患者的粪便标本中回收。回顾性队列研究比较了耐甲氧西林沙门氏菌患者腹泻的严重程度。金黄色葡萄球菌相关性腹泻与粪便中不含该微生物的患者以及肠毒素阴性耐甲氧西林链球菌定植或感染的患者的腹泻之间存在显著性差异。结果：在18个月期间，11名患者发生了与产肠毒素的耐甲氧西林沙门氏菌菌株相关的院内感染相关性腹泻。金黄色。排除了其他常见的细菌、寄生虫和病毒病原体。S.来自11名患者的金黄色葡萄球菌菌株产生葡萄球菌肠毒素A、A和B或D。89%的患者粪便标本中的肠毒素与从粪便中回收的菌株产生的肠毒素相同。病例组腹泻天数多于非耐甲氧西林沙门氏菌组。粪便中的金黄色葡萄球菌（p < 0.001），或随机选择的患者定植或感染肠毒素阴性耐甲氧西林链球菌。结论：我们的研究结果提供了证据，产肠毒素的耐甲氧西林金黄色葡萄球菌菌株。金黄色葡萄球菌可引起医院内寄生虫相关性腹泻。对这种疾病的进一步认识应导致对受影响患者的更迅速和适当的治疗。
OBJECTIVES: The aim of this study is to present new evidence that enterotoxin-producing strains of methicillin-resistant Staphylococcus aureus may cause nosocomial antibiotic-associated diarrhea.METHODS: We conducted a prospective study that utilized standard methods to exclude other bacterial, parasitic, and viral pathogens as causes of nosocomial diarrhea in patients with heavy growth of methicillin-resistant S. aureus in their stool. Staphylococcal enterotoxin assays were performed on S. aureus strains recovered from patients' stools and on stool specimens from affected patients. Retrospective cohort studies compared the severity of diarrhea in patients with methicillin-resistant S. aureus-associated diarrhea with that of patients whose stool did not contain the organism and with patients colonized or infected with enterotoxin-negative methicillin-resistant S. aureus strains.RESULTS: During an 18-month period, 11 patients had nosocomial antibiotic-associated diarrhea associated with enterotoxin-producing strains of methicillin-resistant S. aureus. Other common bacterial, parasitic, and viral pathogens were excluded. S. aureus strains from the 11 patients produced staphylococcal enterotoxin A, A and B, or D. Eighty-nine percent of patients had the same enterotoxin(s) in stool specimens as produced by the strain recovered from their stool. Case patients had a greater number of days of diarrhea than patients without methicillin-resistant S. aureus in their stool (p < 0.001), or randomly selected patients colonized or infected with enterotoxin-negative methicillin-resistant S. aureus (p < 0.001).CONCLUSIONS: Our findings provide evidence that enterotoxin-producing strains of methicillin-resistant S. aureus may cause nosocomial antibiotic-associated diarrhea. Greater recognition of this disease should result in more rapid and appropriate treatment of affected patients.