Schultsz C, Meester H H M, Kranenburg A M H, Savelkoul P H M, Boeijen-Donkers L E A, Kaiser A M, de Bree R, Snow G B, Vandenbroucke-Grauls C J M E
Department of Medical Microbiology and Infection Control, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
J Hosp Infect. 2003 Dec;55(4):269-75. doi: 10.1016/s0195-6701(03)00263-9.
An outbreak of methicillin-resistant Staphylococcus aureus (MRSA) occurred on a head and neck surgical (HNS) ward of a university hospital in Amsterdam. The outbreak lasted from May 2000 until November 2000, and MRSA spread to two intensive care units. Amplified fragment length polymorphism analysis indicated that a single clone was responsible for the outbreak. Phage-typing indicated that this clone was of a type that was uncommon in The Netherlands. Strict isolation of patients, according to the Dutch national guidelines, was instituted. During the outbreak, surveillance culture specimens, from patients, healthcare workers, and the environment, were obtained at regular intervals. MRSA was found in the dust filters of nebulizers through which air from the room was filtered and subsequently humidified. These nebulizers were used to humidify tracheostomies. The dust filters were not maintained according to the guidelines. Restricted use and cleaning and disinfection of all ultra-sonic nebulizers led to termination of the outbreak. The outbreak illustrates that to terminate transmission of outbreak strains of MRSA, meticulous measures are necessary, which not only include strict isolation precautions, but also decontamination of the environment. In addition, it demonstrates the necessity of adhering to cleaning and disinfection guidelines for all medical and nursing equipment used in the hospital.
阿姆斯特丹一家大学医院的头颈外科病房爆发了耐甲氧西林金黄色葡萄球菌（MRSA）感染。疫情从2000年5月持续到2000年11月，MRSA传播到了两个重症监护病房。扩增片段长度多态性分析表明，此次疫情由单一克隆菌株引起。噬菌体分型显示，该克隆菌株在荷兰并不常见。按照荷兰国家指南对患者进行了严格隔离。疫情期间，定期采集患者、医护人员和环境的监测培养标本。在用于过滤并随后加湿病房空气的雾化器的灰尘过滤器中发现了MRSA。这些雾化器用于气管切开术的加湿。灰尘过滤器未按照指南进行维护。对所有超声雾化器进行限制使用、清洁和消毒后，疫情得以终止。此次疫情表明，要终止MRSA疫情菌株的传播，必须采取细致的措施，这不仅包括严格的隔离预防措施，还包括环境去污。此外，它还证明了遵守医院使用的所有医疗和护理设备的清洁和消毒指南的必要性。
