Rafiq Muhammad Salman, Rafiq Muhammad Imran, Khan Taimur, Rafiq Maria, Khan Mah Muneer
Surgical D Unit, Khyber Teaching Hospital, Peshawar, Pakistan.
Medical B Unit, Lady Reading Hospital, Peshawar, Pakistan.
J Pak Med Assoc. 2015 Sep;65(9):915-20.
To determine the effectiveness of simple control measures on the infection status and characteristics of methicillin-resistant Staphylococcus aureus including susceptibility patterns among health professionals and patients in a teaching hospital.
The cross-sectional study was conducted from September 2013 to January 2014, and comprised samples collected from healthcare personnel and patients in the various units of Khyber Teaching Hospital, Peshawar. The specimens were collected before and one month after the implementation of simple control measures for outbreak prevention of methicillin-resistant Staphylococcus aureus. These were tested for culture and antimicrobial susceptibility. Data about methicillin-sensitive and methicillin-resistant Staphylococcus aureus infection, wound characteristics and susceptibility patterns was collected and effectiveness of simple control measures was determined. SPSS 20 was used for statistical analysis.
Of the total 390 isolates, 180(46.2%) were Staphylococcus aureus; 77(19.7%) from healthcare personnel and 103(26.4%) from patients. Of these, 164(42.1%) were methicillin-sensitive and 16(4.1%) were methicillin-resistant. Among the patients, 38(15.1%) methicillin-sensitive and 8(3.2%) methicillin-resistant isolates were recovered from wounds or skin and soft tissues. Pus with 33(13.1%) and 4(1.6%) cases respectively was the second most common source. Among methicillin-resistant isolates, resistance to Linezolid was 0%, all were resistant to Oxacillin, Cefoxitin, Amoxicillin, Cefotaxime and Cephradine, and resistance to both Co-Amoxiclav and Ciprofloxacin was 87.5%. After one month of implementation of simple control measures, the number of methicillin-resistant cases among healthcare professionals and patients dropped from 4(2.9%) and 7(10.8%) to 1(0.7%) and 5(2.7%), respectively.
Methicillin-resistant and methicillin-sensitive Staphylococcus aureus differed in their anti-microbial susceptibility profiles. Selection of antibiotics based on susceptibility and culture is needed for prevention of resistance and effective treatment. A decrease was observed in methicillin-resistant cases with implementation of control measures.
确定简单控制措施对教学医院中耐甲氧西林金黄色葡萄球菌感染状况、特征（包括医护人员和患者的药敏模式）的有效性。
于2013年9月至2014年1月进行横断面研究，样本取自白沙瓦开伯尔教学医院各科室的医护人员和患者。在实施预防耐甲氧西林金黄色葡萄球菌暴发的简单控制措施之前及之后1个月采集标本。对这些标本进行培养和药敏测试。收集有关甲氧西林敏感和耐甲氧西林金黄色葡萄球菌感染、伤口特征及药敏模式的数据，并确定简单控制措施的有效性。使用SPSS 20进行统计分析。
在总共390株分离菌株中，180株（46.2%）为金黄色葡萄球菌；77株（19.7%）来自医护人员，103株（26.4%）来自患者。其中，164株（42.1%）对甲氧西林敏感，16株（4.1%）对甲氧西林耐药。在患者中，从伤口或皮肤及软组织分离出38株（15.1%）对甲氧西林敏感的菌株和8株（3.2%）对甲氧西林耐药的菌株。脓液分别以33例（13.1%）和4例（1.6%）成为第二常见的来源。在耐甲氧西林的分离菌株中，对利奈唑胺的耐药率为0%，所有菌株均对苯唑西林、头孢西丁、阿莫西林、头孢噻肟和头孢拉定耐药，对复方阿莫西林和环丙沙星的耐药率均为87.5%。在实施简单控制措施1个月后，医护人员和患者中耐甲氧西林病例数分别从4例（2.9%）和7例（10.8%）降至1例（0.7%）和5例（2.7%）。
耐甲氧西林和甲氧西林敏感的金黄色葡萄球菌在抗菌药敏谱方面存在差异。为预防耐药性和进行有效治疗，需要根据药敏和培养结果选择抗生素。实施控制措施后，耐甲氧西林病例数有所下降。
