Qin Liang, Masaki Hironori, Gotoh Kenji, Furumoto Akitsugu, Terada Mayumi, Watanabe Kiwao, Watanabe Hiroshi
Division of Infectious Diseases, Department of Infectious Medicine, Kurume University School of Medicine, Kurume.
Intern Med. 2009;48(10):797-803. doi: 10.2169/internalmedicine.48.2036. Epub 2009 May 15.
Moraxella catarrhalis, occasionally, plays the essential role in nosocomial respiratory infection (NRI). Few studies have reported the route by which this organism spreads in a nosocomial infection outbreak. We identified characteristics of the strains isolated from NRI and attempted to reveal the potential nosocomial transmission routes.
A follow-up study has been performed in a Japanese community hospital between July 2002 and January 2003. M. catarrhalis clinical isolates were identified and beta-lactamase production test as well as the minimal inhibitory concentrations (MICs) have been examined. Pulsed-field gel electrophoresis (PFGE) and the multi locus sequence typing method (MLST) have been introduced as the effective "fingerprinting" methods.
A total of 29 strains were isolated from 17 participants; 7 independent DNA fragment patterns were detected by PFGE. Pattern B (defined in this study) was dominant, and was detected both in strains from a health care worker (HCW) and inpatients. In the 9 selected strains analyzed by MLST, 7 unique MLST types were identified, which showed the congruence with the results of PFGE results.
Epidemiological analysis proved the transmission route from patient to patient, and suggested that more studies should be focused on identifying the possible transmission route between HCWs and inpatients.
卡他莫拉菌偶尔在医院获得性呼吸道感染(NRI)中起重要作用。很少有研究报道该菌在医院感染暴发中的传播途径。我们鉴定了从NRI分离出的菌株的特征,并试图揭示潜在的医院传播途径。
2002年7月至2003年1月在一家日本社区医院进行了一项随访研究。鉴定了卡他莫拉菌临床分离株,并检测了β-内酰胺酶产生试验以及最低抑菌浓度(MIC)。脉冲场凝胶电泳(PFGE)和多位点序列分型方法(MLST)已被引入作为有效的“指纹识别”方法。
共从17名参与者中分离出29株菌株;通过PFGE检测到7种独立的DNA片段模式。模式B(本研究中定义)占主导地位,在一名医护人员(HCW)和住院患者的菌株中均有检测到。在通过MLST分析的9株选定菌株中,鉴定出7种独特的MLST类型,其与PFGE结果一致。
流行病学分析证实了患者之间的传播途径,并表明应更多地关注确定医护人员与住院患者之间可能的传播途径。