Hososaka Yasuko, Hanaki Hideaki, Yanagisawa Chie, Yamaguchi Yukie, Matsui Hidehito, Nakae Taiji, Iwata Satoshi, Hayashi Izumi, Sunakawa Keisuke
Kitasato Research Center for Anti-infection Drugs, 5-9-1 Shirokane, Minato-ku, Tokyo 108-0072, Japan.
J Infect Chemother. 2006 Aug;12(4):181-4. doi: 10.1007/s10156-006-0455-x.
We report here an outbreak of beta-lactam-induced vancomycin-resistant methicillin-resistant Staphylococcus aureus (MRSA; BIVR) at one of the Cancer-Institute-affiliated hospitals in Tokyo. We examined a total of 500 strains (100 per year) of clinically isolated MRSA from 1998 to 2002. The detection rates of BIVR in the years 1998, 1999, 2000, 2001, and 2002 were 10%, 9%, 49%, 15%, and 19%, respectively. To investigate the cause of the high incidence of BIVR detection in the year 2000, we carried out pulsed-field gel electrophoresis (PFGE) of the SmaI-digested chromosomal DNA of BIVR and MRSA. The results showed that 96% of the BIVR strains isolated in 2000 were classified as an identical DNA type "A", while only 47% of the MRSA strains were classified as this type. We concluded, based on these results, that this hospital had a nosocomial infection of BIVR in the year 2000. An important message given by this study would be that nosocomial BIVR infection could occur in any hospital where MRSA infection is treated with vancomycin and beta-lactam antibiotics.
我们在此报告东京一家癌症研究所附属医院发生的一起由β-内酰胺诱导的耐万古霉素耐甲氧西林金黄色葡萄球菌（MRSA；BIVR）暴发事件。我们检查了1998年至2002年期间临床分离的总共500株MRSA菌株（每年100株）。1998年、1999年、2000年、2001年和2002年BIVR的检出率分别为10%、9%、49%、15%和19%。为调查2000年BIVR检出率高的原因，我们对BIVR和MRSA经SmaI酶切的染色体DNA进行了脉冲场凝胶电泳（PFGE）。结果显示，2000年分离出的BIVR菌株中有96%被归类为相同的DNA型“A”，而MRSA菌株中只有47%被归类为此型。基于这些结果，我们得出结论，该医院在2000年发生了BIVR医院感染。这项研究传达的一个重要信息是，在任何使用万古霉素和β-内酰胺类抗生素治疗MRSA感染的医院都可能发生医院BIVR感染。
