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耐甲氧西林金黄色葡萄球菌(MRSA)引起的医院获得性伤口感染。

Methicillin-resistant Staphylococcus aureus (MRSA) as a cause of nosocomial wound infections.

机构信息

Institute for Clinical Microbiology, University of Sarajevo Clinics Centre, Bolnicka 25, 71000 Sarajevo, Bosnia and Herzegovina.

出版信息

Bosn J Basic Med Sci. 2010 Feb;10(1):32-7. doi: 10.17305/bjbms.2010.2733.

Abstract

Postoperative wound infections represent about 16% of hospital-acquired infections. Staphylococcus aureus is the most common cause of nosocomial wound infections. Increased frequency of Methicillin-resistant Staphylococcus aureus (MRSA) in hospitalized patients and possibility of vancomycin resistance requires permanent control of MRSA spread in the hospital.The purpose of this study was to analyse the frequency of Methicillin-resistant Staphylococcus aureus (MRSA) in the swabs taken from the surgical wounds, the presence of MRSA infection in surgical departments and to examine antimicrobial susceptibility of MRSA isolates. Wound swabs were examined from January 2006 to December 2008. The isolates were identified by conventional methods. Antimicrobial susceptibility testing was performed by Kirby-Bauer disc-diffusion method as per NCCLS guidelines.A total of 5755 wound swabs were examined: 938 (16,3%) swabs were sterile and 4817 (83,7%) were positive. Staphylococcus aureus was isolated in 1050 (22,0%) swabs and it was the most common cause of wound infections. MRSA was isolated from 12,4% samples in 2006, from 6,7% samples in 2007 and from 3,7% samples during 2008. Wound infections caused by MRSA dominated in the department of plastic surgery (24,4%) and in the department of orthopaedic surgery (24,1%). Antimicrobial susceptibility testing showed that 73% of MRSA isolates were with the same antibiotic sensitivity pattern (antibiotyp)-sensitive only to vancomycin, tetracycline, fucid acid and trimethoprim/sulfamethoxasole. Our results show decreasing of MRSA infection in the surgical wards. These results appear to be maintained with strategies for preventing nosocomial infection: permanent education, strong application of protocols and urging the implementation of strict infection control policy.

摘要

术后伤口感染约占医院获得性感染的 16%。金黄色葡萄球菌是医院获得性伤口感染最常见的原因。住院患者中耐甲氧西林金黄色葡萄球菌(MRSA)的频率增加和万古霉素耐药的可能性要求对医院内 MRSA 传播进行持续控制。本研究的目的是分析从外科伤口拭子中分离出的耐甲氧西林金黄色葡萄球菌(MRSA)的频率、外科病房中 MRSA 感染的存在情况,并检查 MRSA 分离株的抗菌药物敏感性。从 2006 年 1 月至 2008 年 12 月检查了伤口拭子。通过常规方法鉴定分离株。根据 NCCLS 指南,采用 Kirby-Bauer 纸片扩散法进行抗菌药物敏感性测试。共检查了 5755 份伤口拭子:938 份(16.3%)拭子无菌,4817 份(83.7%)为阳性。在 1050 份拭子(22.0%)中分离出金黄色葡萄球菌,是伤口感染最常见的原因。2006 年从 12.4%的样本中分离出 MRSA,2007 年从 6.7%的样本中分离出 MRSA,2008 年从 3.7%的样本中分离出 MRSA。MRSA 引起的伤口感染在整形外科学(24.4%)和矫形外科学(24.1%)中占主导地位。抗菌药物敏感性测试显示,73%的 MRSA 分离株具有相同的抗生素敏感性模式(抗生素型)-仅对万古霉素、四环素、夫西地酸和甲氧苄啶/磺胺甲噁唑敏感。我们的结果显示外科病房中 MRSA 感染减少。这些结果似乎通过预防医院感染的策略得以维持:持续教育、严格执行方案和敦促实施严格的感染控制政策。

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