Köck R, Brakensiek L, Mellmann A, Kipp F, Henderikx M, Harmsen D, Daniels-Haardt I, von Eiff C, Becker K, Hendrix M G R, Friedrich A W
Institute of Hygiene, University Hospital Münster, Münster, Germany.
J Hosp Infect. 2009 Apr;71(4):320-6. doi: 10.1016/j.jhin.2008.12.001. Epub 2009 Feb 6.
Since patient exchange between hospitals sharing a common catchment area might favour regional spread of meticillin-resistant Staphylococcus aureus (MRSA), the reliable detection of patients colonised at admission is crucial. Thus, hospitals in the Dutch-German border area EUREGIO MRSA-net aim at synchronising their local MRSA standards in order to prevent unidentified inter-hospital as well as cross-border spread. This assumes enhanced knowledge of MRSA prevalence and risk factors associated with MRSA carriage at admission. We conducted nasal MRSA screening of all inpatients admitted to 39 German hospitals (in the period 1 November to 30 November 2006) and to one Dutch hospital (in the period 1 July to 30 September 2007) in the EUREGIO MRSA-net. A total of 390 MRSA cases were detected among 25,540 patients screened. The admission prevalence was 1.6 MRSA/100 patients (6.5% of all S. aureus) in the German and 0.5 MRSA/100 patients (1.4% of all S. aureus) in the Dutch part of the border region. Overall, the predominating S. aureus protein A gene (spa) sequence types were t003, t032 and t011. One isolate (t044) carried Panton-Valentine leukocidin (PVL) encoding genes. Altogether, 79% and 67% of all MRSA patients in the German and Dutch regions respectively, were identifiable by the classical nosocomial risk factors assessed. In patients lacking all risk factors assessed, spa types t011 and t034 were predominant (P<0.001).
由于在共同集水区内的医院之间进行患者交流可能会助长耐甲氧西林金黄色葡萄球菌（MRSA）的区域传播，因此可靠检测入院时已定植的患者至关重要。因此，位于荷兰 - 德国边境地区的EUREGIO MRSA网络中的医院旨在同步其当地的MRSA标准，以防止未识别的医院间以及跨境传播。这需要增强对MRSA患病率以及与入院时MRSA携带相关的危险因素的了解。我们对EUREGIO MRSA网络中39家德国医院（2006年11月1日至11月30日期间）和1家荷兰医院（2007年7月1日至9月30日期间）的所有住院患者进行了鼻腔MRSA筛查。在25,540名接受筛查的患者中，共检测到390例MRSA病例。德国边境地区的入院患病率为每100名患者中有1.6例MRSA（占所有金黄色葡萄球菌的6.5%），荷兰边境地区为每100名患者中有0.5例MRSA（占所有金黄色葡萄球菌的1.4%）。总体而言，主要的金黄色葡萄球菌蛋白A基因（spa）序列类型为t003、t032和t011。一株分离株（t044）携带杀白细胞素（PVL）编码基因。分别通过评估的经典医院感染危险因素，德国和荷兰地区所有MRSA患者中可识别的比例分别为79%和67%。在缺乏所有评估危险因素的患者中，spa类型t011和t034占主导地位（P<0.001）。
