Nishijima S, Sugimachi T, Higashida T, Asada Y, Okuda K, Murata K
Department of Dermatology, Kansai Medical University, Osaka, Japan.
J Dermatol. 1992 Jun;19(6):356-61. doi: 10.1111/j.1346-8138.1992.tb03239.x.
Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most important causative microorganisms for nosocomial infections. Recently, the incidence of isolation of MRSA has been increasing every year in Japan and is, notably, much more frequently found in inpatients than in outpatients. Therefore, we have done epidemiological studies of MRSA isolated from medical staff, inpatients, and the hospital environment in one ward of our hospital. Thereafter, we examined the antibiotic susceptibility (ABPC, DMPPC, CET, CMZ, IPM, GM, MINO, OFLX, EM, CLDM, VCM), phage typing, and coagulase typing of these MRSA. MRSA were isolated more frequently from anterior nares of inpatients than from doctors and nurses. MRSA were isolated more frequently from the environment near carriers of MRSA. Coagulase type II and phage type N.T. (not typable) were the dominant types of MRSA in our hospital (69% and 61%). MRSA strains were resistant to most antibiotics with a few exceptions (VCM, IPM, CMZ, CET). The high isolation frequency of MRSA in our hospital seems to suggest that inpatients who are carrying MRSA spread MRSA throughout the hospital environment and that the anterior nares of inpatients are the major MRSA harbor.
耐甲氧西林金黄色葡萄球菌(MRSA)是医院感染最重要的致病微生物之一。近年来,日本MRSA的分离率逐年上升,值得注意的是,在住院患者中发现MRSA的频率远高于门诊患者。因此,我们对我院一个病房的医护人员、住院患者及医院环境中分离出的MRSA进行了流行病学研究。此后,我们检测了这些MRSA的抗生素敏感性(氨苄青霉素、二甲氧苯青霉素、头孢噻肟、头孢孟多、亚胺培南、庆大霉素、米诺环素、氧氟沙星、红霉素、氯碳头孢、万古霉素)、噬菌体分型和凝固酶分型。从住院患者前鼻孔分离出MRSA的频率高于医生和护士。在MRSA携带者附近的环境中更频繁地分离出MRSA。我院MRSA的优势类型为凝固酶II型和N.T.(不可分型)噬菌体型(分别为69%和61%)。除少数抗生素(万古霉素、亚胺培南、头孢孟多、头孢噻肟)外,MRSA菌株对大多数抗生素耐药。我院MRSA的高分离率似乎表明,携带MRSA的住院患者在整个医院环境中传播MRSA,住院患者的前鼻孔是MRSA的主要储存部位。