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埃塞俄比亚北部默克莱医院医护人员中耐甲氧西林金黄色葡萄球菌(MRSA)的鼻腔和手部携带率

Nasal and hand carriage rate of methicillin resistant Staphylococcus aureus (MRSA) among health care workers in Mekelle Hospital, North Ethiopia.

作者信息

Gebreyesus Araya, Gebre-Selassie Solomon, Mihert Adane

机构信息

Department of Medical Microbiology, Immunology and Parasitology, School of Medicine , Mekelle Univesity.

出版信息

Ethiop Med J. 2013 Jan;51(1):41-7.

Abstract

BACKGROUND

Methicillin resistant Staphylococcus aureus (MRSA) is significant major pathogen responsible for hospital and community based infections.

OBJECTIVE

The aim of this study was to assess the nasal and hand carriage of methicillin resistant Staphylococcus aureus in health care workers of Mekelle Hospital

METHODS

The study was carried out during November 2010 to January 2011. Swab samples from both anterior nares and hands were taken. The samples were cultured on mannitol salt agar and incubated aerobically at 37 degrees C for 48 hours. Staphylococcus aureus was identified as nmannitol fermenter and coagulase test positive. Antimicrobial susceptibility test for MRSA was done by disk diffusion method using oxacillin disks. Data were analysed using SPSS version 16 software.

RESULTS

Out of the 177 health care workers screened, 36 (20.3%) of them were methicillin resistant Staphylococcus aureus carriers in their hand and anterior nares. More females, 25(14.1%) were colonized by methicillin resistant Staphylococcus aureus than males 11 (6.2%) (P = 0.044). Nasal carriage of MRSA of 25 (14.1%) was higher than hand carriage 11 (6.2%) (p < 0.05). Nurses and medical doctors had methicillin resistant Staphylococcus aureus carriage rates of 26 (13.6%) and 4 (2.3%), respectively. The isolated MRSA were resistant to multiple antibiotics. The highest resistance was observed for ampicillin (88.9%) and tetracycline (86.1%). Two (5.6%) of the nasal isolates were vancomycin resistant.

CONCLUSION

Methicillin resistant Staphylococcus aureus carriage among health care workers in this study was high. The carriage rate was higher among nurses and doctors. The MRSA isolates were multi drug resistant to other antibiotics. So, the result of this study emphasizes the need of regular surveillance of health care workers. It also calls a need for an effective infection prevention and control program.

摘要

背景

耐甲氧西林金黄色葡萄球菌(MRSA)是引起医院感染和社区感染的重要主要病原体。

目的

本研究旨在评估梅凯勒医院医护人员鼻腔和手部耐甲氧西林金黄色葡萄球菌的携带情况。

方法

研究于2010年11月至2011年1月进行。采集前鼻孔和手部的拭子样本。将样本接种于甘露醇盐琼脂培养基上,在37℃需氧条件下培养48小时。金黄色葡萄球菌被鉴定为甘露醇发酵菌且凝固酶试验呈阳性。采用纸片扩散法,使用苯唑西林纸片对MRSA进行药敏试验。数据使用SPSS 16版软件进行分析。

结果

在筛查的177名医护人员中,有36人(20.3%)手部和前鼻孔携带耐甲氧西林金黄色葡萄球菌。女性携带耐甲氧西林金黄色葡萄球菌的比例更高,有25人(14.1%),而男性为11人(6.2%)(P = 0.044)。MRSA的鼻腔携带率为25人(14.1%),高于手部携带率11人(6.2%)(p < 0.05)。护士和医生的耐甲氧西林金黄色葡萄球菌携带率分别为26人(13.6%)和4人(2.3%)。分离出的MRSA对多种抗生素耐药。对氨苄西林(88.9%)和四环素(86.1%)的耐药性最高。鼻腔分离株中有两株(5.6%)对万古霉素耐药。

结论

本研究中,医护人员耐甲氧西林金黄色葡萄球菌的携带率较高。护士和医生中的携带率更高。MRSA分离株对其他抗生素具有多重耐药性。因此,本研究结果强调了对医护人员进行定期监测的必要性。同时也呼吁制定有效的感染预防与控制计划。

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