Chen M L, Chang S C, Pan H J, Hsueh P R, Yang L S, Ho S W, Luh K T
Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.
J Formos Med Assoc. 1999 Jun;98(6):426-32.
In Taiwan, the frequency of nosocomial infections caused by methicillin-resistant Staphylococcus aureus (MRSA) has increased rapidly during the past 10 years. To investigate the epidemiology of MRSA infections, a total of 140 MRSA isolates collected at National Taiwan University Hospital from 1992 to 1996 were characterized by pulsed-field gel electrophoresis (PFGE) profiles and antibiotypes, as determined with the disk diffusion method. Among these isolates, six PFGE types (with 20 subtypes) and six antibiotypes were identified. Antibiotyping proved to be a poor method of epidemiologic analysis, because almost all of the MRSA isolates analyzed shared a very similar multidrug-resistant antibiotype. Most MRSA infections and colonizations in this hospital were due to the spread of strains belonging to three major PFGE types (A, B, and C). However, the major type changed in different years with types A, B, and C being predominant in 1992 through 1993, 1994 through 1995, and 1996, respectively. The three major PFGE types spread easily throughout the hospital wards, presumably carried by health care workers and environmental contamination. Our results demonstrate that there was a dominant strain spreading in our hospital each year and the dominant strain may shift in different years.
在台湾，耐甲氧西林金黄色葡萄球菌（MRSA）引起的医院感染发生率在过去10年中迅速上升。为了调查MRSA感染的流行病学情况，对1992年至1996年期间在台湾大学医院收集的140株MRSA分离株，通过脉冲场凝胶电泳（PFGE）图谱和采用纸片扩散法测定的抗菌谱型进行了特征分析。在这些分离株中，鉴定出了六种PFGE型（含20个亚型）和六种抗菌谱型。抗菌谱型分析被证明是一种较差的流行病学分析方法，因为几乎所有分析的MRSA分离株都具有非常相似的多重耐药抗菌谱型。该医院的大多数MRSA感染和定植是由于属于三种主要PFGE型（A、B和C）的菌株传播所致。然而，主要类型在不同年份有所变化，A、B和C型分别在1992年至1993年、1994年至1995年和1996年占主导地位。这三种主要的PFGE型很容易在医院病房中传播，推测是由医护人员和环境污染携带的。我们的结果表明，每年在我们医院都有一种优势菌株在传播，并且优势菌株可能在不同年份发生变化。
