Benoit Stephen R, Estivariz Concepción, Mogdasy Cristina, Pedreira Walter, Galiana Antonio, Galiana Alvaro, Bagnulo Homero, Gorwitz Rachel, Fosheim Gregory E, McDougal Linda K, Jernigan Daniel
Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Emerg Infect Dis. 2008 Aug;14(8):1216-23. doi: 10.3201/eid1408.071183.
Community-associated MRSA (CA-MRSA) strains have emerged in Uruguay. We reviewed Staphylococcus aureus isolates from a large healthcare facility in Montevideo (center A) and obtained information from 3 additional hospitals on patients infected with CA-MRSA. An infection was defined as healthcare-onset if the culture was obtained >48 hours after hospital admission. At center A, the proportion of S. aureus infections caused by CA-MRSA increased from 4% to 23% over 2 years; the proportion caused by healthcare-associated MRSA (HA-MRSA) decreased from 25% to 5%. Of 182 patients infected with CA-MRSA, 38 (21%) had healthcare-onset infections. Pulsed-field gel electrophoresis determined that 22 (92%) of 24 isolates were USA1100, a community strain. CA-MRSA has emerged in Uruguay and appears to have replaced HA-MRSA strains at 1 healthcare facility. In addition, CA-MRSA appears to cause healthcare-onset infections, a finding that emphasizes the need for infection control measures to prevent transmission within healthcare settings.
社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）菌株已在乌拉圭出现。我们回顾了蒙得维的亚一家大型医疗机构（A中心）的金黄色葡萄球菌分离株，并从另外3家医院获取了关于感染CA-MRSA患者的信息。如果在入院48小时后进行培养，则感染被定义为医院获得性感染。在A中心，由CA-MRSA引起的金黄色葡萄球菌感染比例在2年内从4%增至23%；由医院相关耐甲氧西林金黄色葡萄球菌（HA-MRSA）引起的比例从25%降至5%。在182例感染CA-MRSA的患者中，38例（21%）发生了医院获得性感染。脉冲场凝胶电泳确定，24株分离株中有22株（92%）为USA1100，这是一种社区菌株。CA-MRSA已在乌拉圭出现，并且似乎已在一家医疗机构中取代了HA-MRSA菌株。此外，CA-MRSA似乎会引起医院获得性感染，这一发现强调了采取感染控制措施以防止在医疗机构内传播的必要性。
