牙买加西印度大学医院莫匹罗星耐药性检测及耐甲氧西林金黄色葡萄球菌的分布情况。

The detection of mupirocin resistance and the distribution of methicillin-resistant Staphylococcus aureus at the University Hospital of the West Indies, Jamaica.

作者信息

Nicholson A M, Thorns C, Wint H, Didier M, Willis R, McMorris N, Castle D, Maharaj N, Orrett F A

机构信息

Department of Microbiology, The University of the West Indies, Kingston 7, Jamaica, West Indies.

出版信息

West Indian Med J. 2010 Oct;59(5):509-13.

PMID:21473397

Abstract

OBJECTIVES

The objectives of this study were to determine the susceptibility of Methicillin Resistant Staphylococcus aureus (MRSA) isolates to Mupirocin and other antimicrobial agents and to record the prevalence and distribution of this organism at the University Hospital of the West Indies (UHWI).

METHODS

MRSA isolates collected between January 1, 2008 and December 31, 2008, were tested for low and high level resistance to Mupirocin. Susceptibility testing to other antibiotics including cotrimoxazole, minocycline, tetracycline, clindamycin, erythromycin, gentamicin and vancomycin was also done. Laboratory records for all patients from whom MRSA was recovered were reviewed and data on type and source of isolates, clinical diagnosis, history of previous hospitalization and use of mupirocin were extracted. In addition, the laboratory records for 2004 and 2005 were also reviewed to determine prevalence during these periods.

RESULTS

Seven per cent of Staphylococcus aureus isolates were resistant to methicillin (MRSA) and of these, 30% and 24% showed low level and high level resistance to mupirocin, respectively. Ninety-four per cent of MRSA strains were resistant to erythromycin while 52% showed resistance to clindamycin. Resistance to tetracycline, co-trimoxazole and minocycline was 27%, 12% and 6%, respectively, while about one-third of the isolates were resistant to gentamicin. There was no resistance to vancomycin. More than half (58%) of the isolates were from skin and soft tissue specimens while isolates from respiratory and urinary tracts and the bloodstream accounted for 19%, 13% and 4%, respectively. There has been a steady increase in prevalence from 4% in 2004 to 5% in 2007 and 7% in 2008.

CONCLUSION

Resistance of MRSA to mupirocin appears to be an emerging problem at the UHWI and must be monitored carefully. There is also significant resistance to commonly used antimicrobial agents and strict adherence to antibiotic policy is required to preserve the usefulness of these agents.

摘要

目的

本研究的目的是确定耐甲氧西林金黄色葡萄球菌（MRSA）分离株对莫匹罗星及其他抗菌药物的敏感性，并记录该菌在西印度群岛大学医院（UHWI）的流行情况和分布。

方法

对2008年1月1日至2008年12月31日期间收集的MRSA分离株进行莫匹罗星低水平和高水平耐药性检测。还对包括复方新诺明、米诺环素、四环素、克林霉素、红霉素、庆大霉素和万古霉素在内的其他抗生素进行敏感性检测。回顾了所有分离出MRSA的患者的实验室记录，并提取了有关分离株类型和来源、临床诊断、既往住院史和莫匹罗星使用情况的数据。此外，还回顾了2004年和2005年的实验室记录，以确定这些时期的流行情况。

结果

7%的金黄色葡萄球菌分离株对甲氧西林耐药（MRSA），其中30%和24%分别对莫匹罗星表现出低水平和高水平耐药。94%的MRSA菌株对红霉素耐药，而52%对克林霉素耐药。对四环素、复方新诺明和米诺环素的耐药率分别为27%、12%和6%，约三分之一的分离株对庆大霉素耐药。对万古霉素无耐药。超过一半（58%）的分离株来自皮肤和软组织标本，而来自呼吸道、泌尿道和血液的分离株分别占19%、13%和4%。流行率从2004年的4%稳步上升至2007年的5%和2008年的7%。