A molecular epidemiologic study of methicillin-resistant Staphylococcus aureus infection in patients undergoing middle ear surgery
A molecular epidemiologic study of methicillin-resistant Staphylococcus aureus infection in patients undergoing middle ear surgery
复制标题
中耳手术患者耐甲氧西林金黄色葡萄球菌感染的分子流行病学研究
DOI：
10.1007/s004050050074
复制
发表时间：
1998
影响因子：
2.6
通讯作者：
Hee
中科院分区：
文献类型：
--
作者：
H. Suh;Y. Jeon;J. S. Song;Soon Jae Hwang;Hee
近年来，我院中耳手术后耐甲氧西林金黄色葡萄球菌（MRSA）感染的发生率有所上升。大多数这些感染被认为是医院获得性的，当医务人员与MRSA感染的患者接触时，可能无意中将病原体传播给其他患者。为了防止进一步传播，必须选择并根除这些MRSA感染源和传播途径。因此，有必要确定从感染患者中分离的MRSA菌株是否与从医务人员中获得的菌株相同，以证明医务人员和患者之间的生物体相互传播。在1994年12月6日和1996年6月17日两个不同的时间点，对在高丽大学九老医院耳鼻喉科工作的医务人员的前鼻孔和手进行了监测细菌培养。应用核糖核酸分型和Southern杂交技术对12株来自医疗携带者的MRSA菌株和60株来自中耳手术后MRSA感染患者耳道的MRSA菌株进行比较。结果，从用EcoRI进行的核糖分型中鉴定出六种不同的MRSA菌株（I、II、III、IV、V和VI型）。一种不同的亚型，I型菌株，是医学携带者和患者中最常见的菌株。结果还表明，10例药物携带者的6株MRSA和30例患者的20株MRSA首次培养时均为I型核糖体。在第二次监测培养中，2株医学携带者分离株和30例患者的13株分离株具有相同的I型菌株。72株MRSA中有41株（56.9%）具有相同的核糖体型。经医疗载体治疗和严格预防措施的应用后，术后MRSA感染率在第一次培养后从11.9%降至5.7%，在第二次培养后从9.0%降至7.7%。这些发现证实了MRSA可以在医务人员和患者之间传播，有效的预防措施可以降低术后感染率。
The incidence of methicillin-resistantStaphylococcus aureus(MRSA) infections after middle ear surgery has recently increased at our hospital. Most of these infections were thought to be hospital-acquired when medical personnel in contact with an MRSA-infected patient may have inadvertently transmitted the pathogen to other patients. To prevent further transmission it is essential that such sources of MRSA infection and transmission routes be selected out and eradicated. Therefore, it is necessary to determine whether the strains of MRSA isolated from infected patients are identical to those obtained from medical personnel in order to prove a reciprocal transmission of organisms between medical personnel and patients. Surveillance bacterial cultures from the anterior nares and hands of medical personnel working in the Department of Otolaryngology, Korea University Guro Hospital, were performed at two different time points: 6 December 1994 and 17 June 1996. Ribotyping with Southern blot technique was used to compare 12 MRSA strains from medical carriers with 60 strains identified from the otorrhea of MRSA-infected patients undergoing middle ear surgery. As result, six different MRSA strains were identified (types I, II, III, IV, V and VI) from ribotyping with EcoR1. One distinct subtype, type I strain, was the most frequently identified strain in both medical carriers and patients. Results also showed that 6 MRSA isolates from 10 medical carriers and 20 from 30 patients contained type I ribotype at first culture. Two medical carriers’ isolates and 13 isolates from 30 patients shared the same type I strain at the second surveillance culture. In all, 41 out of 72 MRSA strains (56.9%) shared an identical ribotype pattern. Postoperative MRSA infection rates after treatment of medical carriers and the application of rigorous preventive procedures decreased from 11.9 to 5.7% after first culture and 9.0 to 7.7% following second cultures. These findings confirm that MRSA transmission can occur between medical personnel and patients and that effective preventive measures can reduce the postoperative infection rate.