Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Kweishan, Taoyuan, Taiwan ; Chang Gung University College of Medicine, Kweishan, Taoyuan, Taiwan.
PLoS One. 2013 Nov 26;8(11):e82472. doi: 10.1371/journal.pone.0082472. eCollection 2013.
Health care workers (HCWs) are at the interface between hospitals and communities. The survey for methicillin-resistant Staphylococcus aureus (MRSA) carriage among HCWs has mostly been conducted to investigate outbreaks or endemics. Community-associated MRSA are prevalent among children in Taiwan. We conducted this study to better understand the carriage rate of MRSA among pediatricians in non-outbreak situations in Taiwan,.
A total of 220 pediatricians from Taiwan who attended the annual meeting of Taiwan Pediatric Association in April, 2010 were recruited to participate in this study and were sampled from the nares for the detection of MRSA by polymerase chain reaction (PCR) and further by culture. The following molecular analyses were performed, including pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), typing of staphylococcal cassette chromosome mec (SCCmec) and the presence of Panton-Valentine leukocidin (PVL) genes.
MRSA was detected from 15 attendees (6.8%) by PCR. MRSA-colonized attendees had a significantly lower rate (0.041) of working in the medical center, while borderline significantly higher rate of working in the Regional Hospital (p=0.056), than those without MRSA colonization. From those 15 samples, 12 MRSA isolates were identified by culture and molecularly characterized. Three PFGE patterns, two sequence types (ST 59, ST 508), and two SCCmec types (IV and VT) were identified, respectively. Five isolates, including three carrying SCCmec types VT, were PVL-positive. All 12 isolates were susceptible to vancomycin, teicoplanin, linezolid, fusidic acid, trimethoprim/sulfamethoxazole, and doxycyclin, and resistant to penicillin.
CONCLUSION/SIGNIFICANCE: Around seven percent of pediatricians in Taiwan harbored CA-MRSA in their nares.
医护人员（HCWs）处于医院和社区之间的界面上。针对耐甲氧西林金黄色葡萄球菌（MRSA）携带情况对 HCWs 的调查主要是为了调查暴发或流行情况。社区相关性 MRSA 在台湾的儿童中很普遍。我们进行这项研究是为了更好地了解台湾非暴发情况下儿科医生中 MRSA 的携带率。
从 2010 年 4 月参加台湾儿科协会年会的 220 名台湾儿科医生中招募了 220 名儿科医生参与本研究，并对其鼻腔进行采样，通过聚合酶链反应（PCR）和培养进一步检测 MRSA。进行了以下分子分析，包括脉冲场凝胶电泳（PFGE）、多位点序列分型（MLST）、葡萄球菌盒染色体 mec 型（SCCmec）分型和 Panton-Valentine 白细胞毒素（PVL）基因的存在。
通过 PCR 检测到 15 名与会者（6.8%）MRSA。MRSA 定植的与会者在医疗中心工作的比例明显较低（0.041），而在区域医院工作的比例略高（p=0.056），与无 MRSA 定植的与会者相比。在这 15 个样本中，通过培养和分子特征鉴定出 12 个 MRSA 分离株。分别鉴定出三种 PFGE 模式、两种序列型（ST59、ST508）和两种 SCCmec 型（IV 和 VT）。其中 5 株包括 3 株携带 SCCmec 型 VT 的分离株为 PVL 阳性。所有 12 株分离株均对万古霉素、替考拉宁、利奈唑胺、夫西地酸、复方磺胺甲噁唑和多西环素敏感，对青霉素耐药。
结论/意义：大约 7%的台湾儿科医生鼻腔携带 CA-MRSA。
