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沙特阿拉伯沙克拉综合医院收治患者的耐甲氧西林金黄色葡萄球菌鼻腔定植情况

Methicillin-resistant Staphylococcus aureus Nasal Carriage Among Patients Admitted at Shaqra General Hospital in Saudi Arabia.

作者信息

Alhussaini Mohammed S

机构信息

Department of Clinical Laboratory Science, College of Applied Medical Sciences, Shaqra University, Saudi Arabia.

出版信息

Pak J Biol Sci. 2016;19(5):233-238. doi: 10.3923/pjbs.2016.233.238.

Abstract

BACKGROUND AND OBJECTIVE

Methicillin-resistant Staphylococcus aureus (MRSA) have been causing increasing problems in hospitals and nursing homes worldwide. Limited number of studies in Saudi Arabia has attempted to investigate infection and risk factors associated with nosocomial acquired MRSA. The present study was undertaken to determine the occurrence, prevalence, antibiotic susceptibility pattern and genetic characteristics of MRSA among admitted cases at Shaqra General Hospital (Saudi Arabia).

METHODOLOGY

This study was conducted from October, 2014 to March, 2015. Nasal swabs were taken from 220 patients (105 males and 115 females) admitted at Shaqra General Hospital. The isolates were identified as S. aureus based on morphology, Gram stain, catalase test, coagulase test and mannitol salt agar fermentation. Antibiotic susceptibility testing of MRSA was performed with standard disk diffusion method. All methicillin-resistant isolates were examined for the existence of the mecA gene by PCR technique.

RESULTS

Of the 220 patients, 90 (40.91%) were found to be nasal carriers of S. aureus. Among these 90 S. aureus isolates, 48 (21.82%) were MRSA. A statistically significant difference was only found for antibiotics usage between those with and without MRSA colonization. Antibiotic susceptibility pattern of isolated MRSA showed high susceptibility to vancomycin, linezolid, rifampicin, teicoplanin, complete resistance to penicillin, ampicillin, oxacillin and cefoxitin and intermediate resistance to amikacin, ciprofloxacin, teicoplanin, tetracycline and vancomycin.

CONCLUSION

A high prevalence of multidrug-resistant MRSA nasal carriage was found. The identification of MRSA carriers is a step towards establishing a control policy for MRSA and helps to identify measures needed to reduce colonization pressure.

摘要

背景与目的

耐甲氧西林金黄色葡萄球菌(MRSA)在全球范围内的医院和疗养院中引发的问题日益增多。沙特阿拉伯进行的相关研究数量有限,旨在调查医院获得性MRSA感染及其危险因素。本研究旨在确定沙特阿拉伯沙赫拉综合医院收治病例中MRSA的发生情况、流行率、抗生素敏感性模式及基因特征。

方法

本研究于2014年10月至2015年3月进行。从沙赫拉综合医院收治的220例患者(105例男性和115例女性)中采集鼻拭子。根据形态学、革兰氏染色、过氧化氢酶试验、凝固酶试验和甘露醇盐琼脂发酵,将分离株鉴定为金黄色葡萄球菌。采用标准纸片扩散法对MRSA进行抗生素敏感性测试。通过聚合酶链反应(PCR)技术检测所有耐甲氧西林分离株中mecA基因的存在情况。

结果

在220例患者中,90例(40.91%)被发现是金黄色葡萄球菌的鼻携带者。在这90株金黄色葡萄球菌分离株中,48株(21.82%)为MRSA。仅在有无MRSA定植的患者之间,抗生素使用情况存在统计学显著差异。分离出的MRSA的抗生素敏感性模式显示,对万古霉素、利奈唑胺、利福平、替考拉宁高度敏感,对青霉素、氨苄西林、苯唑西林和头孢西丁完全耐药,对阿米卡星、环丙沙星、替考拉宁、四环素和万古霉素中度耐药。

结论

发现多药耐药MRSA鼻定植的患病率较高。识别MRSA携带者是制定MRSA控制政策的第一步,有助于确定降低定植压力所需的措施。

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