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[哥伦比亚一家医院重症监护病房耐甲氧西林金黄色葡萄球菌定植:表型和分子特征分析]

[Methicillin-resistant Staphylococcus aureus colonization in a Colombian hospital intensive care unit: phenotypic and molecular characterization].

作者信息

Olarte Narda María, Valderrama Ismael Alberto, Reyes Karlo Roberto, Garzón Martha Isabel, Escobar Javier Antonio, Castro Betsy Esperanza, Vanegas Natasha

机构信息

Vigilancia Epidemiológica, Hospital El Tunal, Bogotá, DC, Colombia.

出版信息

Biomedica. 2010 Jul-Sep;30(3):353-61.

Abstract

INTRODUCTION

Methicillin-resistant Staphylococcus aureus (MRSA) cause nosocomial and community infections. MRSA colonization in hospitals has been described as an important risk factor during hospitalization.

OBJECTIVE

The colonization characteristics of MRSA was described using the tools of molecular biology.

MATERIALS AND METHODS

Between February 2007 and February 2008, 705 patients entering a Colombian intensive care unit (ICU) were screened for MRSA by taking nasopharyngeal samples. For 683 of these patients, a weekly follow-up was provided after they left the ICU. The susceptibility of each S. aureus isolate was tested against 11 antibiotics using agar dilution methods. Sixty two percent (62.0%) of the MRSA isolates were characterized at genetic and molecular level with the detection of resistant genes, SCCmec typing using PCR and the genetic profile with pulsed field gel electrophoresis (PFGE).

RESULTS

Of the 705 patients screened at entry to the ICU, 182 (25.8%) were colonized by S. aureus, and of these, 51 (7.2%) were MRSA. Of the 683 patients with follow-up, 62 (9.1%) were infected by MRSA contracted in the hospital ICU. The prevalence of the Chilean clone was 76.5% at entry and 88.9% for follow-up patients. Of the 113 patients colonized with MRSA, nosocomial infection was present in 18 patients (16.0%). Three community-acquired MRSA isolates related to the USA300-0114 pandemic clone were identified. These were also positive for Panton-Valentine leucidin cytotoxin genes of S.aureus.

CONCLUSIONS

This is the first report in Colombia of patients colonized with CA-MRSA-ST8-SCCmec IVc isolates, and it is a probable source of dissemination of this bacteria in Colombian hospitals.

摘要

引言

耐甲氧西林金黄色葡萄球菌(MRSA)可引发医院感染和社区感染。医院内MRSA定植被描述为住院期间的一个重要风险因素。

目的

运用分子生物学工具描述MRSA的定植特征。

材料与方法

2007年2月至2008年2月期间,对进入哥伦比亚重症监护病房(ICU)的705例患者采集鼻咽样本,筛查MRSA。其中683例患者在离开ICU后接受每周一次的随访。采用琼脂稀释法检测每株金黄色葡萄球菌对11种抗生素的敏感性。62.0%的MRSA分离株通过检测耐药基因、采用聚合酶链反应(PCR)进行葡萄球菌染色体盒式甲氧西林耐药基因(SCCmec)分型以及利用脉冲场凝胶电泳(PFGE)进行基因图谱分析,在基因和分子水平进行了特征鉴定。

结果

在进入ICU时接受筛查的705例患者中,182例(25.8%)被金黄色葡萄球菌定植,其中51例(7.2%)为MRSA。在683例接受随访的患者中,62例(9.1%)感染了在医院ICU感染的MRSA。智利克隆株的患病率在入院时为76.5%,随访患者中为88.9%。在113例被MRSA定植的患者中,18例(16.0%)发生了医院感染。鉴定出3株与USA300 - 0114大流行克隆相关的社区获得性MRSA分离株。这些分离株的金黄色葡萄球菌杀白细胞素细胞毒素基因也呈阳性。

结论

这是哥伦比亚首次报告CA - MRSA - ST8 - SCCmec IVc分离株定植患者的情况,它可能是这种细菌在哥伦比亚医院传播的一个来源。

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