Erasmus University Medical Center, Department of Medical Microbiology & Infectious Diseases, Postbus 2040, 3000 CA Rotterdam, The Netherlands.
J Clin Microbiol. 2010 Jan;48(1):202-7. doi: 10.1128/JCM.01499-09. Epub 2009 Nov 18.
The frequency of and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) transmission from a MRSA index person to household contacts were assessed in this prospective study. Between January 2005 and December 2007, 62 newly diagnosed MRSA index persons (46 patients and 16 health care workers) and their 160 household contacts were included in the study analysis. Transmission of MRSA from an index person to household contacts occurred in nearly half of the cases (47%; n = 29). These 29 index persons together had 84 household contacts, of which two-thirds (67%; n = 56) became MRSA positive. Prolonged exposure time to MRSA at home was a significant risk factor for MRSA transmission to household contacts. In addition, MRSA colonization at least in the throat, younger age, and eczema in index persons were significantly associated with MRSA transmission; the presence of wounds was negatively associated with MRSA transmission. Furthermore, an increased number of household contacts and being the partner of a MRSA index person were household-related risk factors for MRSA acquisition from the index person. No predominant pulsed-field gel electrophoresis (PFGE) type was observed to be transmitted more frequently than other PFGE types. To date, screening household contacts and providing MRSA eradication therapy to those found positive simultaneously with the index person is not included in the "search-and-destroy" policy. We suggest including both in MRSA prevention guidelines, as this may reduce further spread of MRSA.
本前瞻性研究评估了耐甲氧西林金黄色葡萄球菌(MRSA)从 MRSA 感染个体向家庭接触者传播的频率和危险因素。在 2005 年 1 月至 2007 年 12 月期间,纳入了 62 例新诊断的 MRSA 感染个体(46 例患者和 16 例医护人员)及其 160 名家庭接触者进行研究分析。MRSA 从感染个体向家庭接触者传播的情况接近一半(47%;n=29)。这 29 例感染个体共有 84 名家庭接触者,其中三分之二(67%;n=56)MRSA 检测阳性。在家中与 MRSA 长时间接触是 MRSA 传播给家庭接触者的重要危险因素。此外,MRSA 定植于感染个体的咽喉部、年龄较小、个体患有湿疹与其 MRSA 传播显著相关;感染个体存在伤口与其 MRSA 传播呈负相关。此外,家庭接触者数量增加以及与 MRSA 感染个体为伴侣,是从感染个体处获得 MRSA 的家庭相关危险因素。未观察到特定的脉冲场凝胶电泳(PFGE)型比其他 PFGE 型更频繁地传播。迄今为止,筛查家庭接触者并在与感染个体同时发现阳性时为其提供 MRSA 清除治疗,并未纳入“搜索-破坏”策略中。我们建议将其纳入 MRSA 预防指南中,因为这可能会减少 MRSA 的进一步传播。