McMurray Claire L, Hardy Katherine J, Verlander Neville Q, Hawkey Peter M
Heart of England NHS Foundation Trust, Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK.
Institute of Microbiology and Infection, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK.
J Med Microbiol. 2015 Dec;64(12):1489-1495. doi: 10.1099/jmm.0.000182. Epub 2015 Oct 6.
Staphylococci are a significant cause of hospital-acquired infection. Nasal carriage of Staphylococcus aureus is an important risk factor for infection in surgical patients and coagulase-negative staphylococci (CNS) are a major cause of prosthetic joint infections. The impact that antibiotic surgical prophylaxis has on the nasal carriage of staphylococci has not been studied. Daily nasal swabs were taken from 63 patients who received antibiotic surgical prophylaxis and 16 patients who received no antibiotics. Total aerobic bacterial count, S. aureus and CNS were enumerated by culture from nasal swabs. Representative isolates were typed by staphylococcal interspersed repeat units (SIRU) typing and PFGE, and MICs to nine antibiotics were determined. After antibiotic administration, there was a reduction in S. aureus counts (median - 2.3 log(10)c.f.u. ml(- 1)) in 64.0 % of S. aureus carriers, compared with only a 0.89 log(10)c.f.u. ml(- 1) reduction in 75.0 % of S. aureus carriers who did not receive antibiotics. A greater increase in the nasal carriage rate of meticillin-resistant CNS was observed after antibiotic surgical prophylaxis compared with hospitalization alone, with increases of 16.4 and 4.6 %, respectively. Antibiotic-resistant S. epidermidis carriage rate increased by 16.6 % after antibiotic administration compared with 7.5 % with hospitalization alone. Antibiotic surgical prophylaxis impacts the nasal carriage of both S. aureus and CNS.
葡萄球菌是医院获得性感染的重要原因。金黄色葡萄球菌的鼻腔携带是外科手术患者感染的重要危险因素，凝固酶阴性葡萄球菌（CNS）是人工关节感染的主要原因。抗生素外科预防对葡萄球菌鼻腔携带的影响尚未得到研究。对63例接受抗生素外科预防的患者和16例未接受抗生素的患者进行每日鼻拭子采样。通过鼻拭子培养来计数总需氧菌数、金黄色葡萄球菌和CNS。通过葡萄球菌散布重复单元（SIRU）分型和脉冲场凝胶电泳（PFGE）对代表性分离株进行分型，并测定其对九种抗生素的最低抑菌浓度（MIC）。抗生素给药后，64.0%的金黄色葡萄球菌携带者的金黄色葡萄球菌计数减少（中位数-2.3 log(10) c.f.u. ml(-1)），而未接受抗生素的金黄色葡萄球菌携带者中只有75.0%的人减少了0.89 log(10) c.f.u. ml(-1)。与仅住院相比，抗生素外科预防后耐甲氧西林CNS的鼻腔携带率增加更为明显，分别增加了16.4%和4.6%。抗生素给药后，耐抗生素表皮葡萄球菌的携带率增加了16.6%，而仅住院时为7.5%。抗生素外科预防会影响金黄色葡萄球菌和CNS的鼻腔携带情况。
