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在一个发展中国家的健康儿童中进行社区获得性耐甲氧西林金黄色葡萄球菌的鼻腔携带情况筛查。

Nasal carriage screening of community-associated methicillin resistant Staphylococcus aureus in healthy children of a developing country.

作者信息

Mobasherizadeh Sina, Shojaei Hasan, Havaei Seyed Asghar, Mostafavizadeh Kamyar, Davoodabadi Fazlollah, Khorvash Farzin, Kushki Ali Mehrabi, Daei-Naser Abbas, Ghanbari Fahimeh

机构信息

Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Adv Biomed Res. 2016 Aug 30;5:144. doi: 10.4103/2277-9175.187400. eCollection 2016.

Abstract

BACKGROUND

The rapid emergence and spread of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has raised considerable public health concern in both developed and developing countries. The current study aimed to address the extent of this phenomenon in healthy preschool children of a developing country.

MATERIALS AND METHODS

We conducted a prospective study from April 2013 to March 2014 on 410 healthy 2-6 years old preschool children in Isfahan, Iran. Demographic medical data and nasal samples were collected from the participating children. Isolates were identified as S. aureus and MRSA based on microbiological and molecular tests, including the presence of eap and mecA genes.

RESULTS

The overall prevalence of S. aureus and CA-MRSA nasal carriage was 28% (115/410) and 6.1% (25/410), respectively. The identity of isolates was confirmed by molecular assay. The factors that were independently associated with nasal carriage of S. aureus were: Children crowding in day-care nurseries and income level of families. A total of 20/90 (22.2%) of methicillin-susceptible S. aureus and all 25 CA-MRSA displayed multiple drug resistance to 3-8 antibiotics.

CONCLUSIONS

The current report reflects issues and concerns that the high rate of colonization by CA-MRSA in Iranian healthy children provides obliging evidence that MRSA have established a foothold in the community and are emerging as important health threatening pathogens. It is suggested that we need more effective infection control measures to prevent transmission of nasal CA-MRSA in healthy preschool children.

摘要

背景

社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)的迅速出现和传播在发达国家和发展中国家都引起了相当大的公共卫生关注。本研究旨在探讨这一现象在一个发展中国家健康学龄前儿童中的程度。

材料与方法

我们于2013年4月至2014年3月对伊朗伊斯法罕的410名2至6岁健康学龄前儿童进行了一项前瞻性研究。收集了参与研究儿童的人口统计学医学数据和鼻拭子样本。根据微生物学和分子检测,包括eap和mecA基因的存在情况,将分离株鉴定为金黄色葡萄球菌和MRSA。

结果

金黄色葡萄球菌和CA-MRSA鼻携带的总体患病率分别为28%(115/410)和6.1%(25/410)。通过分子检测确认了分离株的身份。与金黄色葡萄球菌鼻携带独立相关的因素有:儿童在日托托儿所的拥挤程度和家庭收入水平。90株甲氧西林敏感金黄色葡萄球菌中有20株(22.2%)以及所有25株CA-MRSA对3至8种抗生素表现出多重耐药性。

结论

本报告反映了一些问题和担忧,即伊朗健康儿童中CA-MRSA的高定植率提供了确凿证据,表明MRSA已在社区中立足,并正在成为威胁健康的重要病原体。建议我们需要更有效的感染控制措施来预防健康学龄前儿童中鼻CA-MRSA的传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a2a/5025912/6f4b6325ea83/ABR-5-144-g002.jpg

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本文引用的文献

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Prevalence of Community-Acquired Methicillin-Resistant Staphylococcus aureus Nasal Colonization Among Children.
J Clin Diagn Res. 2014 Dec;8(12):DC12-5. doi: 10.7860/JCDR/2014/9986.5276. Epub 2014 Dec 5.
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Editorial Commentary: Duration of Colonization With Methicillin-Resistant Staphylococcus aureus: A Question With Many Answers.
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