利比亚的黎波里医院中耐甲氧西林金黄色葡萄球菌（MRSA）的错误鉴定。

Misidentification of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals in Tripoli, Libya.

机构信息

Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, Al Fateh University, Tripoli, Libya.

出版信息

Libyan J Med. 2010 Nov 3;5. doi: 10.3402/ljm.v5i0.5230.

DOI:10.3402/ljm.v5i0.5230

PMID:21483574

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3066754/

Abstract

BACKGROUND

Methicillin-resistant Staphylococcus aureus (MRSA) is a nosocomial (hospital-acquired) pathogen of exceptional concern. It is responsible for life-threatening infections in both the hospital and the community.

AIMS

To determine the frequency of MRSA misidentification in hospitals in Tripoli, Libya using current testing methods.

METHODS

One hundred and seventy S. aureus isolates previously identified as MRSA were obtained from three hospitals in Tripoli. All isolates were reidentified by culturing on mannitol salt agar, API 20 Staph System and retested for resistance to methicillin using the cefoxitin disk diffusion susceptibility test and PBP2a. D-tests and vancomycin E-tests (Van-E-tests) were also performed for vancomycin-resistant isolates.

RESULTS

Of the 170 isolates examined, 86 (51%) were confirmed as MRSA (i.e. 49% were misidentified as MRSA). Fifteen (17%) of the confirmed MRSA strains exhibited inducible clindamycin resistance. Of the 86 confirmed MRSA isolates, 13 (15%) were resistant to mupirocin, 53 (62%) were resistant to ciprofloxacin, 41 (48%) were resistant to trimethoprim-sulfamethoxazole, and none were resistant to linezolid. Although disc-diffusion testing indicated that 23 (27%) of the isolates were resistant to vancomycin, none of the isolates were vancomycin-resistant by Van-E-test.

CONCLUSIONS

Misidentification of nosocomial S. aureus as MRSA is a serious problem in Libyan hospitals. There is an urgent need for the proper training of microbiology laboratory technicians in standard antimicrobial susceptibility procedures and the implementation of quality control programs in microbiology laboratories of Libyan hospitals.

摘要

背景

耐甲氧西林金黄色葡萄球菌（MRSA）是一种医院获得性（医院内获得）的病原体，尤其令人关注。它可导致医院和社区内危及生命的感染。

目的

使用当前的检测方法确定利比亚的黎波里医院中 MRSA 鉴定错误的频率。

方法

从的黎波里的三家医院获得了先前鉴定为 MRSA 的 170 株金黄色葡萄球菌分离株。所有分离株均通过甘露醇盐琼脂、API 20 Staph 系统培养重新鉴定，并使用头孢西丁纸片扩散药敏试验和 PBP2a 重新测试对甲氧西林的耐药性。还对万古霉素耐药分离株进行了 D-试验和万古霉素 E-试验（Van-E-试验）。

结果

在检查的 170 株分离株中，86 株（51%）确认为 MRSA（即 49%被错误鉴定为 MRSA）。15 株（17%）确认为 MRSA 的菌株表现出诱导性克林霉素耐药性。在 86 株确认的 MRSA 分离株中，13 株（15%）对莫匹罗星耐药，53 株（62%）对环丙沙星耐药，41 株（48%）对甲氧苄啶-磺胺甲恶唑耐药，无一株对利奈唑胺耐药。虽然纸片扩散试验表明 23 株（27%）分离株对万古霉素耐药，但通过 Van-E-试验，没有一株分离株对万古霉素耐药。