Otaolea Santacoloma L, Eiros Bouza J M, Ortiz de Lejarazu R, Carrero González P, Chaves Sánchez F, Luquero Alcalde F J
Servicio de Análisis Clínicos, Hospital General de Segovia.
Rev Esp Quimioter. 2007 Sep;20(3):339-45.
The observation of an increasing number of methicillin-resistant Staphylococcus aureus (MRSA) isolates in some population groups prompted us to study the risk factors and the epidemiological profile of S. aureus nasal carriage in healthy adults 65 years of age and older residing in the province of Segovia. Attention was particularly focused on the possibility that some of the infections were community-acquired. We conducted a prospective and observational study of people who usually visited senior citizen centers in the province of Segovia (Carbonero, Cuéllar, Cantalejo) and its capital. The analysis period took place between January and May 2003. Infections were classified as community-acquired, hospital-acquired or health-care associated. Isolates of methicillin-resistant (MRSA) and methicillin-susceptible S. aureus (MSSA) were studied by pulsed-field gel electrophoresis (PFGE). There were 34 (19.5%) The prevalence of nasal carriage of S. aureus was 19.5% and that for MRSA was 1.1%. Female sex was significantly associated with the carriage state. All S. aureus isolates were mupirocin-susceptible. 100% susceptibility and specificity was obtained through latex agglutination testing. The molecular study showed that the transmission for MRSA was monoclonal and that for MSSA was more policlonal. The results presented here form the basis for similar studies in other Spanish senior citizen centers and provide evidence that MRSA strains are beginning to circulate and are becoming significantly established within the community, thus highlighting the need for implementing control strategies to prevent dissemination.
在某些人群中,耐甲氧西林金黄色葡萄球菌(MRSA)分离株数量不断增加,这促使我们对居住在塞哥维亚省的65岁及以上健康成年人中金黄色葡萄球菌鼻腔定植的危险因素和流行病学特征进行研究。我们特别关注了部分感染为社区获得性感染的可能性。我们对经常前往塞哥维亚省(卡尔维尼罗、库埃利亚尔、坎塔莱霍)及其省会老年人中心的人群进行了一项前瞻性观察研究。分析期为2003年1月至5月。感染被分类为社区获得性、医院获得性或医疗保健相关感染。通过脉冲场凝胶电泳(PFGE)对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)分离株进行了研究。金黄色葡萄球菌鼻腔定植率为19.5%,MRSA定植率为1.1%。女性与定植状态显著相关。所有金黄色葡萄球菌分离株对莫匹罗星敏感。乳胶凝集试验的敏感性和特异性均为100%。分子研究表明,MRSA的传播是单克隆的,而MSSA的传播则更多是多克隆的。本文给出的结果为西班牙其他老年人中心开展类似研究奠定了基础,并提供了证据表明MRSA菌株已开始在社区内传播并显著定植,从而凸显了实施控制策略以防止传播的必要性。