Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands.
Br J Gen Pract. 2010 Dec;60(581):902-6. doi: 10.3399/bjgp10X544078.
The extent to which GPs serve as a reservoir for antibiotic-resistant Staphylococcus aureus is unknown and not well studied.
To determine the prevalence of nasal S. aureus carriage among GPs in the Netherlands, as well as the antimicrobial resistance and the genotypes of isolated S. aureus.
Observational, point-prevalence, and cross-sectional study.
GPs attending the annual conference of the Dutch College of General Practitioners in 2006.
Nasal swabs were randomly taken from 395 GPs and analysed for the presence of S. aureus. Antimicrobial susceptibility was determined by a microbroth dilution method and the genotypes by spa typing, which was associated with multilocus sequence typing.
Of the GPs, 129/395 (33%; 95% confidence interval [CI] = 28 to 37%) were carriers of S. aureus. No meticillin-resistant S. aureus (MRSA) was found. Resistance was observed to penicillin (71%; 95% CI = 63 to 79%), fusidic acid (7%; 95% CI = 3 to 13%), and clarithromycin (6%; 95% CI = 3 to 12%). In 72% of the isolates, an MRSA-related genotype of S. aureus was found.
The low antibiotic resistance found among S. aureus of GPs suggests that GPs are not a reservoir of antibiotic-resistant S. aureus strains. The relatively high resistance to fusidic acid, which has not previously been described in the Netherlands and is mostly because of antibiotic use, suggests that patients infect GPs and not the other way round. GPs may be at risk for nasal carriage of S. aureus with an MRSA-related genotype.
全科医生是否是耐抗生素金黄色葡萄球菌的储存库尚不清楚，也未得到很好的研究。
确定荷兰全科医生中鼻腔金黄色葡萄球菌携带率，以及分离的金黄色葡萄球菌的抗生素耐药性和基因型。
观察性、时点患病率和横断面研究。
2006 年荷兰全科医生学院年会上参加的全科医生。
从 395 名全科医生中随机采集鼻腔拭子，分析金黄色葡萄球菌的存在情况。通过微量肉汤稀释法测定抗生素敏感性，通过 spa 分型确定基因型，spa 分型与多位点序列分型相关联。
395 名全科医生中，129/395（33%；95%置信区间[CI] = 28 至 37%）为金黄色葡萄球菌携带者。未发现耐甲氧西林金黄色葡萄球菌（MRSA）。青霉素（71%；95%CI = 63 至 79%）、夫西地酸（7%；95%CI = 3 至 13%）和克拉霉素（6%；95%CI = 3 至 12%）耐药。在 72%的分离株中，发现了与 MRSA 相关的金黄色葡萄球菌基因型。
在全科医生的金黄色葡萄球菌中发现的低抗生素耐药性表明，全科医生不是耐抗生素金黄色葡萄球菌菌株的储存库。对夫西地酸的耐药性相对较高，这在荷兰以前没有描述过，主要是因为抗生素的使用，表明患者感染了全科医生，而不是相反。全科医生可能存在携带与 MRSA 相关基因型的金黄色葡萄球菌的鼻腔携带风险。
