Low prevalence of methicillin-resistant Staphylococcus aureus (MRSA) at hospital admission in the Netherlands:: the value of search and destroy and restrictive antibiotic use
Low prevalence of methicillin-resistant Staphylococcus aureus (MRSA) at hospital admission in the Netherlands:: the value of search and destroy and restrictive antibiotic use
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DOI：
10.1016/j.jhin.2004.01.026
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发表时间：
2004-04-01
影响因子：
6.9
通讯作者：
Verbrugh, HA
中科院分区：
文献类型：
--
作者：
Wertheim, HFL;Vos, MC;Verbrugh, HA
在荷兰，不到 1% 的金黄色葡萄球菌临床分离株具有甲氧西林耐药性 (MRSA)。国家搜索和销毁政策可防止耐甲氧西林金黄色葡萄球菌（MRSA）流行。一些 MRSA 爆发与存在 MRSA 携带风险的患者无关。本研究旨在测量入院时无 MRSA 携带危险因素的患者中 MRSA 的患病率。荷兰四家医院对 1999 年至 2000 年期间入住非外科部门的患者进行了 MRSA 鼻腔携带筛查。将鼻拭子在 5% 羊血琼脂 (BA) 上划线，浸没在选择性肉汤中，并在 35°C 下孵育两到三天。通过凝集试验鉴定怀疑为金黄色葡萄球菌的菌落。通过自动化系统和额外的苯唑西林纸片扩散进行药敏试验。通过 DNA 杂交测试和 mecA PCR 证实了甲氧西林耐药性。通过脉冲场电泳 (PFGE) 对 MRSA 菌株进行基因分型。百分之二十四 (2332/9859) 的患者是金黄色葡萄球菌鼻带菌者。只有 3 名 (0.03%) 患者是 MRSA 携带者。这些患者没有被遣返，在筛查前也不知道他们是否是 MRSA 携带者。基因分型显示，这些菌株没有克隆相关性，也与患者入院医院的 MRSA 爆发无关。我们的结论是，由于荷兰的搜查和销毁政策以及严格的抗生素处方，在荷兰医院的常规入院（不包括高风险的外国入院）中，MRSA 患病率较低（0.03%）。 (C) 2004 年医院感染协会。由爱思唯尔有限公司出版。保留所有权利。
In the Netherlands, less than 1% of clinical isolates of Staphylococcus aureus are methicillin-resistant (MRSA). A national search and destroy policy prevents MRSA from becoming endemic. Some MRSA outbreaks cannot be related to patients at risk for MRSA carriage. This study was designed to measure the prevalence of MRSA among patients without risk factors for MRSA carriage at the time of admission to the hospital. In four Dutch hospitals, patients admitted to non-surgical departments in the period 1999 - 2000 were screened for MRSA nasal carriage. Nasal swabs were streaked on 5% sheep blood agar (BA), submerged in a selective broth, and incubated for two to three days at 35 degreesC. Colonies suspected of being S. aureus were identified with an agglutination test. Susceptibility testing was performed by an automated system and additional oxacillin disk diffusion. Methicillin resistance was confirmed by a DNA hybridization test and mecA PCR. MRSA strains were genotyped by pulsed-field get electrophoresis (PFGE). Twenty-four percent (2332/9859) of the patients were S. aureus nasal carriers. Only three (0.03%) patients were MRSA carriers. These patients were not repatriated, nor known to be MRSA carriers before screening. Genotyping revealed that the strains were not clonally related and were not related to MRSA outbreaks in the hospital where the patients were admitted. We conclude that at routine admission to a Dutch hospital (excluding high-risk foreign admissions) the MRSA prevalence is low (0.03%), due to the Dutch search and destroy policy and restrictive antibiotic prescribing. (C) 2004 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.