Department of Microbiology and Immunology, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
J Clin Pathol. 2012 Feb;65(2):178-82. doi: 10.1136/jclinpath-2011-200436. Epub 2011 Oct 29.
Meticillin-resistant Staphylococcus aureus (MRSA) strains isolated in Tawam Hospital, a tertiary care hospital in the United Arab Emirates, were examined in order to understand the reasons for a doubling of its incidence between 2003 and 2008 while maintaining the same infection control measures.
All consecutive non-duplicate clinically relevant MRSA isolates recovered between January and December 2003 and between May and October 2008 were studied. The antibiotic susceptibility, pulsed field gel electrophoresis, toxin gene, staphylococcal cassette chromosome mec (SCCmec), spa, agr and multilocus sequence types of the strains were tested.
In 2003, typical healthcare-associated (HA-MRSA) genotypes (ST239-MRSA-III, ST22-MRSA-IV and ST5-MRSA-II) represented the majority (61.5%) of the isolates. By 2008 this pattern had changed and clonal types considered as community-associated (CA) MRSA comprised 73.1% of the strains with ST80-MRSA-IV, ST5-MRSA-IV and ST1-MRSA with non-typable SCCmec types being the most frequent. However, further epidemiological investigations showed that only one-third of the CA-MRSA infections were actually acquired in the community, indicating that CA-MRSA clones have entered and spread within the hospital.
The emergence of CA-MRSA clones with subsequent entry to and spread within the hospital has contributed to the increasing incidence of MRSA observed in Tawam Hospital and probably also in other hospitals in the UAE.
为了了解 2003 年至 2008 年间，在阿拉伯联合酋长国的一家三级保健医院——塔瓦姆医院，耐甲氧西林金黄色葡萄球菌（MRSA）的发病率增加了一倍，而感染控制措施却保持不变的原因，对该医院分离的 MRSA 菌株进行了研究。
研究了 2003 年 1 月至 12 月和 2008 年 5 月至 10 月期间连续收集的所有非重复临床相关 MRSA 分离株。对菌株的抗生素敏感性、脉冲场凝胶电泳、毒素基因、葡萄球菌盒式染色体 mec（SCCmec）、spa、agr 和多位点序列类型进行了检测。
2003 年，典型的医疗机构相关（HA-MRSA）基因型（ST239-MRSA-III、ST22-MRSA-IV 和 ST5-MRSA-II）占分离株的大多数（61.5%）。到 2008 年，这种模式发生了变化，被认为是社区相关（CA）MRSA 的克隆类型占菌株的 73.1%，其中 ST80-MRSA-IV、ST5-MRSA-IV 和 ST1-MRSA 最常见，且 SCCmec 类型不可分型。然而，进一步的流行病学调查表明，只有三分之一的 CA-MRSA 感染实际上是在社区获得的，这表明 CA-MRSA 克隆已经进入并在医院内传播。
CA-MRSA 克隆的出现以及随后在医院内的进入和传播，导致了塔瓦姆医院和阿联酋其他医院观察到的 MRSA 发病率的增加。
