Salmenlinna S, Lyytikäinen O, Kotilainen P, Scotford R, Siren E, Vuopio-Varkila J
National Public Health Institute, Department of Bacteriology, Helsinki, Finland.
Eur J Clin Microbiol Infect Dis. 2000 Feb;19(2):101-7. doi: 10.1007/s100960050438.
This study reports the recent trends in the occurrence of methicillin-resistant Staphylococcus aureus in Finland, with special focus on characterization of the strains linked to interhospital epidemics and local outbreaks. Between 1981 and 1997, the annual number of methicillin-resistant Staphylococcus aureus isolations ranged from 89 to 272. Of all blood isolates of Staphylococcus aureus reported to the National Infectious Disease Register during the period 1995-97 (n = 2049), only six were resistant to methicillin. Between 1992 and 1997, typing analysis by various methods (i.e., antibiogram, phage typing, ribotyping, and pulsed-field gel electrophoresis) identified 18 different strains capable of causing intrahospital outbreaks or interhospital epidemics. These 18 strains were separated into 13 different ribotypes and 14 major pulsed-field gel electrophoresis types. Multiresistance was investigated as a possible marker for epidemicity. Eight of the ten interhospitally spread strains were multiresistant compared to only three of the eight intrahospitally spread outbreak strains. More than one-third of the epidemic and local outbreak strains were suspected to be of foreign origin. The majority (6 of 10) of the epidemics were localized in southern and western Finland, and the largest epidemic, which occurred in the Helsinki metropolitan area, involved over 200 persons. Thus far, the epidemics have remained primarily intracity problems, and only two strains have become endemic.
本研究报告了芬兰耐甲氧西林金黄色葡萄球菌的近期发病趋势，特别关注与医院间流行和局部暴发相关菌株的特征。1981年至1997年期间，耐甲氧西林金黄色葡萄球菌的年度分离数在89至272株之间。在1995 - 1997年期间向国家传染病登记处报告的所有金黄色葡萄球菌血培养分离株（n = 2049）中，仅有6株对甲氧西林耐药。1992年至1997年期间，通过多种方法（即抗菌谱、噬菌体分型、核糖体分型和脉冲场凝胶电泳）进行的分型分析确定了18种能够引起医院内暴发或医院间流行的不同菌株。这18种菌株被分为13种不同的核糖体分型和14种主要的脉冲场凝胶电泳型。对多重耐药性作为流行性的可能标志物进行了研究。在10株医院间传播的菌株中，有8株具有多重耐药性，而在8株医院内传播的暴发菌株中只有3株具有多重耐药性。超过三分之一的流行株和局部暴发株被怀疑来自国外。大多数（10例中的6例）流行发生在芬兰南部和西部，最大的一次流行发生在赫尔辛基大都市区，涉及200多人。迄今为止，这些流行主要仍是城市内部的问题，仅有两株已成为地方流行株。
