Kerttula Anne-Marie, Lyytikäinen Outi, Virolainen Anni, Finne-Soveri Harriet, Agthe Niina, Vuopio-Varkila Jaana
Department of Bacterial and Inflammatory Diseases, National Public Health Institute, Mannerheimintie, Helsinki, Finland.
Scand J Infect Dis. 2007;39(11-12):996-1001. doi: 10.1080/00365540701466207. Epub 2007 Jun 21.
We studied colonization with methicillin-resistant and -sensitive Staphylococcus aureus (MRSA, MSSA) in the second largest nursing home in Finland, in which the residents volunteered had their nostrils, throats, perineums, skin lesions, and catheter exit sites swabbed, and catheter urines cultured. The specimens were cultured onto non-selective and selective agar, with or without enrichment in salt-containing trypticase soy broth (TSB). S. aureus was identified by routine methods, methicillin resistance was detected by oxacillin and cefoxitin disk diffusion and MIC E-tests, and GenoType MRSA -test was used for mecA gene confirmation. A total of 663 cultures were obtained from 213 residents. Of those, 165 specimens (25%) from 94 residents (44%) were positive for S. aureus, and 3 specimens (0.4%) from 2 (0.9%) residents were positive for MRSA. Of the 165 S. aureus isolates, 31 (19%) from 25 (27%) residents were found only from sites other than nostrils (30 MSSA and 1 MRSA). TSB enrichment detected additional 33 (5%) S. aureus isolates (32 MSSA and 1 MRSA), resulting in 8 (5%) additional residents. None of the MRSA strains would have been found if only nostrils and throat had been screened, and no enrichment broth had been used.
我们在芬兰第二大养老院研究了耐甲氧西林金黄色葡萄球菌（MRSA）和甲氧西林敏感金黄色葡萄球菌（MSSA）的定植情况。在该养老院中，自愿参与的居民的鼻孔、咽喉、会阴、皮肤损伤处以及导尿管出口部位均被擦拭取样，同时对导尿管尿液进行培养。将标本接种于非选择性和选择性琼脂培养基上，接种前有的在含胰蛋白酶大豆肉汤（TSB）的含盐培养基中增菌培养，有的则未增菌。金黄色葡萄球菌通过常规方法鉴定，甲氧西林耐药性通过苯唑西林和头孢西丁纸片扩散法以及MIC E试验检测，GenoType MRSA试验用于确认mecA基因。共从213名居民中获得663份培养样本。其中，94名居民（44%）的165份标本（25%）金黄色葡萄球菌检测呈阳性，2名居民（0.9%）的3份标本（0.4%）MRSA检测呈阳性。在165株金黄色葡萄球菌分离株中，25名居民（27%）的31株（19%）仅在鼻孔以外的部位发现（30株MSSA和1株MRSA）。TSB增菌培养又检测出33株（5%）金黄色葡萄球菌分离株（32株MSSA和1株MRSA），涉及8名（5%）额外的居民。如果仅筛查鼻孔和咽喉且未使用增菌肉汤，将无法检测到任何MRSA菌株。
