Kooistra-Smid Mirjam, van Dijk Sjoukje, Beerthuizen Gerard, Vogels Willem, van Zwet Ton, van Belkum Alex, Verbrugh Henri
Regional Public Health Laboratory, van Ketwich Verschuurlaan 92, 9721 SW, Groningen, The Netherlands.
Burns. 2004 Feb;30(1):27-33. doi: 10.1016/j.burns.2003.09.014.
The aim of this study was to investigate carriage of Staphylococcus aureus by patients and health care workers (HCW) and to define the genetic relationship of S. aureus strains isolated from burn wounds. At admission, 19/55 (34.5%) patients carried S. aureus in their nose and/or throat. Of this group, 95% subsequently colonized their burn wounds with S. aureus. Molecular analysis showed that in 78% of these cases the burn-wound colonizing strain was identical to the strain carried at admission. Importantly, 23/36 (64%) patients who did not carry S. aureus at admission also developed burn-wound colonization. In this group, three dominant genotypes were identified as colonizing strains of burn wounds. These clones represented also the majority (59%) of S. aureus strains cultured from the nose and/or throat of health care workers and patients. If patients were admitted to one of the Intensive Care rooms burn wounds of non-carriers were not colonized with S. aureus as long as they remained in such isolation. Only patients who carried S. aureus at admission developed burn-wound colonization with that genotype they carried in the nose or throat. Both carriage in patients and health care workers and auto-infection play a crucial role in (cross-) colonization events.
本研究的目的是调查患者和医护人员（HCW）金黄色葡萄球菌的携带情况，并确定从烧伤创面分离的金黄色葡萄球菌菌株的遗传关系。入院时，19/55（34.5%）的患者鼻腔和/或咽喉部携带金黄色葡萄球菌。在这组患者中，95%随后烧伤创面被金黄色葡萄球菌定植。分子分析表明，在这些病例中，78%的烧伤创面定植菌株与入院时携带的菌株相同。重要的是，23/36（64%）入院时未携带金黄色葡萄球菌的患者也发生了烧伤创面定植。在这组患者中，鉴定出三种主要基因型为烧伤创面的定植菌株。这些克隆也代表了从医护人员和患者鼻腔和/或咽喉部分离培养的金黄色葡萄球菌菌株的大多数（59%）。如果患者入住重症监护病房之一，只要非携带者的烧伤创面保持隔离状态，就不会被金黄色葡萄球菌定植。只有入院时携带金黄色葡萄球菌的患者，其烧伤创面才会被鼻腔或咽喉部携带的该基因型金黄色葡萄球菌定植。患者和医护人员的携带以及自身感染在（交叉）定植事件中都起着至关重要的作用。
