[一家三级医院一名医护人员携带耐甲氧西林金黄色葡萄球菌储存库与抗生素软膏]

[Antibiotic ointments and methicillin-resistant Staphylococcus aureus with a reservoir in a healthcare worker in a tertiary hospital].

作者信息

Molina-Cabrillana Jesús, Del Rosario-Quintana Cristóbal, Tosco-Núñez Tomas, Dorta-Hung Elena, Quori Anna, Martín-Sánchez Antonio M

机构信息

Servicio de Medicina Preventiva, Complejo Hospitalario Universitario Insular-Materno Infantil (CHUIMI), Las Palmas de Gran Canaria, España.

出版信息

Enferm Infecc Microbiol Clin. 2013 Oct;31(8):511-5. doi: 10.1016/j.eimc.2012.10.002. Epub 2012 Dec 4.

DOI:10.1016/j.eimc.2012.10.002

PMID:23218870

Abstract

BACKGROUND

Methicillin-resistant Staphylococcus aureus (MRSA) has become an important hospital-acquired pathogen, with transfer of the organism from a carrier or infected patient to uninfected patients by the hands or clothing of staff as the main mode of transmission.

METHODS

Investigation of a cluster of new cases of MRSA resistant to mupirocin and fusidic acid, using epidemiological and microbiological resources.

RESULTS

From September 2010 to February 2012, sixteen patients had at least one culture positive for MRSA resistant to mupirocin and fusidic acid. Some not apparently related cases and outbreaks appeared. By analysing cultures taken from patients and staff using pulsed-field gel electrophoresis, it was demonstrated that most likely this situation was started by an auxiliary nurse who was a carrier of the MRSA. Healthcare worker decontamination using oral antibiotic therapy was unsuccessful. Eventually, the situation was controlled by placing the carrier in a different job, with no further cases to date (September, 2012).

CONCLUSION

This report illustrates the risk of nosocomial transmission linked to care delivered by healthcare workers.

摘要

背景

耐甲氧西林金黄色葡萄球菌（MRSA）已成为一种重要的医院获得性病原体，该病原体通过工作人员的手或衣物从携带者或感染患者传播至未感染患者是主要传播方式。

方法

利用流行病学和微生物学资源，对一组对莫匹罗星和夫西地酸耐药的MRSA新病例进行调查。

结果

2010年9月至2012年2月，16例患者至少有一次培养结果显示对莫匹罗星和夫西地酸耐药的MRSA呈阳性。出现了一些看似无关的病例和疫情暴发。通过脉冲场凝胶电泳分析患者和工作人员的培养物，结果表明这种情况很可能是由一名携带MRSA的辅助护士引发的。采用口服抗生素疗法对医护人员进行消毒未成功。最终，通过将携带者调至其他岗位控制了局面，截至2012年9月未再出现新病例。