Pavilonyte Zaneta, Kaukeniene Renata, Antusevas Aleksandras, Pavilonis Alvydas
Department of Microbiology, Kaunas University of Medicine, A. Mickeviciaus 9, 44307 Kaunas, Lithuania.
Medicina (Kaunas). 2008;44(8):593-600.
OBJECTIVE. To determine the prevalence of Staphylococcus aureus strains among hospitalized patients at the beginning of their hospitalization and during their treatment and the resistance of strains to antibiotics, and to evaluate epidemiologic characteristics of these strains. PATIENTS AND METHODS. Sixty-one patients treated at the Department of Cardiac, Thoracic and Vascular Surgery were examined. Identification of Staphylococcus aureus strains was performed using plasmacoagulase and DNase tests. The resistance of Staphylococcus aureus to antibiotics, beta-lactamase production, phagotypes, and phagogroups were determined. The isolated Staphylococcus aureus strains were tested for resistance to methicillin by performing disc diffusion method using commercial discs (Oxoid) (methicillin 5 microg per disk and oxacillin 1 microg per disk). RESULTS. A total of 297 Staphylococcus aureus strains were isolated. On the first day of hospitalization, the prevalence rate of Staphylococcus aureus strains among patients was 67.3%, and it statistically significantly increased to 91.8% on days 7-10 of hospitalization (P<0.05). During hospitalization, patients were colonized with Staphylococcus aureus strains resistant to cephalothin (17.6% of patients, P<0.05), cefazolin (14.6%, P<0.05), tetracycline (15.0%, P<0.05), gentamicin (37.7%, P<0.001), doxycycline (30.7%, P<0.001), and tobramycin (10.6%, P>0.05). Three patients (4.9%) were colonized with methicillin-resistant Staphylococcus aureus strains, belonging to phage group II phage type 3A and phage group III phage types 83A and 77; 22.6-25.5% of Staphylococcus aureus strains were nontypable. During hospitalization, the prevalence rate of phage group II Staphylococcus aureus strains decreased from 39.6% to 5.7% (P<0.05) and the prevalence rate of phage group III Staphylococcus aureus strains increased to 29.5% (P<0.001). CONCLUSIONS. Although our understanding of Staphylococcus aureus is increasing, well-designed community-based studies with adequate risk factor analysis are required to elucidate further the epidemiology of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus. Surveillance of methicillin-resistant Staphylococcus aureus provides relevant information on the extent of the methicillin-resistant Staphylococcus aureus epidemic, identifies priorities for infection control and the need for adjustments in antimicrobial drug policy, and guides intervention programs.
目的。确定住院患者入院初期及治疗期间金黄色葡萄球菌菌株的流行情况及其对抗生素的耐药性,并评估这些菌株的流行病学特征。患者与方法。对心脏、胸科和血管外科治疗的61例患者进行了检查。采用血浆凝固酶和DNA酶试验鉴定金黄色葡萄球菌菌株。测定金黄色葡萄球菌对抗生素的耐药性、β-内酰胺酶产生情况、噬菌体型和噬菌组。通过使用市售药敏纸片(Oxoid)(每片含5μg甲氧西林和1μg苯唑西林)进行纸片扩散法检测分离出的金黄色葡萄球菌菌株对甲氧西林的耐药性。结果。共分离出297株金黄色葡萄球菌菌株。入院第一天,患者中金黄色葡萄球菌菌株的流行率为67.3%,在住院第7 - 10天统计学显著增加至91.8%(P<0.05)。住院期间,患者感染了对头孢噻吩耐药的金黄色葡萄球菌菌株(17.6%的患者,P<0.05)、头孢唑林(14.6%,P<0.05)、四环素(15.0%,P<0.05)、庆大霉素(37.7%,P<0.001)、强力霉素(30.7%,P<0.001)和妥布霉素(10.6%,P>0.