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意大利一家医院新生儿病房发生皮肤和软组织感染爆发,系社区获得性耐甲氧西林金黄色葡萄球菌 USA300 克隆所致。

Outbreak of skin and soft tissue infections in a hospital newborn nursery in Italy due to community-acquired meticillin-resistant Staphylococcus aureus USA300 clone.

机构信息

Istituto Superiore di Sanità, Rome, Italy.

出版信息

J Hosp Infect. 2013 Jan;83(1):36-40. doi: 10.1016/j.jhin.2012.09.017. Epub 2012 Nov 14.

Abstract

BACKGROUND

Community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA) is responsible for severe infections in previously healthy people acquired in the community in different areas of the world.

AIM

To report an outbreak of CA-MRSA in a hospital newborn nursery in northern Italy in September-October 2010, its investigation and control measures.

METHODS

The epidemiology of the outbreak is reported. The investigation included screening neonates, parents and staff for MRSA carriage. Molecular strain typing was performed on MRSA isolates.

FINDINGS

The outbreak affected nine neonates with three severe infections. In addition, four mothers had postpartum mastitis, and three mothers and one father had skin infection. The outbreak strain belonged to the USA300 CA-MRSA clone. Asymptomatic carriage of the outbreak strain was found among neonates, parents and hospital staff. The implementation of appropriate infection control measures in the hospital terminated the outbreak.

CONCLUSIONS

To our knowledge, this is the first report of a hospital outbreak caused by the USA300 CA-MRSA clone in Europe. It is important to reinforce infection control measures, particularly in high-risk groups, such as neonates, to prevent USA300 from becoming endemic in European hospitals.

摘要

背景

社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)可导致世界不同地区的社区中原本健康的人群发生严重感染。

目的

报告 2010 年 9-10 月意大利北部一家医院新生儿病房发生的 CA-MRSA 暴发情况,以及其调查和控制措施。

方法

报告了暴发的流行病学情况。调查包括对 MRSA 携带者进行筛查新生儿、父母和工作人员。对 MRSA 分离株进行分子菌株分型。

结果

暴发影响了 9 名新生儿,其中 3 名发生严重感染。此外,4 名母亲产后患乳腺炎,3 名母亲和 1 名父亲患有皮肤感染。暴发菌株属于 USA300 CA-MRSA 克隆。在新生儿、父母和医院工作人员中发现了无症状携带暴发菌株的情况。在医院实施了适当的感染控制措施后,暴发得到了控制。

结论

据我们所知,这是欧洲首例由 USA300 CA-MRSA 克隆引起的医院暴发。加强感染控制措施非常重要,特别是在新生儿等高危人群中,以防止 USA300 在欧洲医院流行。

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