Akoua Koffi C, Dje K, Toure R, Guessennd N, Acho B, Faye Kette H, Loukou Y G, Dosso M
UFR Sciences Médicales d'Abidjan, Laboratoire de Bactériologie-Virologie Institut Pasteur de Côte d'Ivoire, 01 BP 490, Abidjan.
Dakar Med. 2004;49(1):70-4.
To determine the prevalence of méticillino-résistant Staphylococcus aureus (MRSA) among health care personnel in Abidjan teaching hospitals as well as their resistance profile against other antibiotics, 592 health care personnel from various surgical and medical services: the intensive care unit, gynaecology and obstetrics and third-degree burns services of the Cocody, Treichville and Yopougon Teaching Hospitals were included. The previous nasal pits of each subject included were swabbed. The isolation of S. aureus strains was run in a Chapman medium followed by Identification based on morphological and biochemical characteristics. The resistance profile of the strains to antibiotics was determined by standard Kirby-Bauer disk diffusion method and a 1 microg disc of oxacillin was used for the detection of meticillin-resistance S. aureus strains according to NCCLS (National Committee for Clinical Laboratory Standards) guidelines. 269 members of the studied personnel were carriers of S. aureus, either a rate of portage of 45.4%. Among the 269 S. aureus isolates, 38.7% were MRSA strains and the carriage rate of MRSA in the population was 17.8%. The health care personnel working in surgery was the more colonized (36.7%) follow-up of those of the medical services (31.4%) and of the the intensive care unit (12.4%). A variable proportion of strains of MRSA also expressed resistances to the other families of antibiotics: 27% to aminosids of which 13.5% of phénotype kanamycine, tobramycine, gentamycine (KTG), 58.7% to macrolids and related (MLS), 37.5% to fluoroquinolons, 14.4% to cyclines and 40% to the cotrimoxazole. This confirms their multi-resistant character. The prevalence of MRSA carriage among health care personnel is high; this personnel constitutes an infectious risk for the hospitalized patients who are so exposed to nosocomial infections caused by MRSA.
为确定阿比让教学医院医护人员中耐甲氧西林金黄色葡萄球菌(MRSA)的流行情况及其对其他抗生素的耐药谱,纳入了来自不同外科和内科服务科室的592名医护人员,这些科室包括:科科迪、特雷什维尔和约普贡教学医院的重症监护病房、妇产科和三度烧伤科。对纳入的每个受试者先前的鼻前庭进行擦拭取样。金黄色葡萄球菌菌株的分离在查普曼培养基中进行,随后根据形态学和生化特征进行鉴定。根据美国国家临床实验室标准委员会(NCCLS)指南,采用标准的 Kirby-Bauer 纸片扩散法测定菌株对抗生素的耐药谱,并用1微克的苯唑西林纸片检测耐甲氧西林金黄色葡萄球菌菌株。研究人员中有269人携带金黄色葡萄球菌,携带率为45.4%。在269株金黄色葡萄球菌分离株中,38.7%为MRSA菌株,人群中MRSA的携带率为17.8%。从事外科工作的医护人员携带率最高(36.7%),其次是内科服务人员(31.4%)和重症监护病房人员(12.4%)。不同比例的MRSA菌株还对其他抗生素家族表现出耐药性:对氨基糖苷类耐药的占27%,其中对卡那霉素、妥布霉素、庆大霉素(KTG)表型耐药的占13.5%;对大环内酯类及相关药物(MLS)耐药的占58.7%;对氟喹诺酮类耐药的占37.5%;对四环素类耐药的占14.4%;对复方新诺明耐药的占40%。这证实了它们的多重耐药特性。医护人员中MRSA携带率很高;这些人员对住院患者构成感染风险,使患者容易遭受由MRSA引起的医院感染。