Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan; Department of Biology, National Changhua University of Education, Changhua, Taiwan.
Int J Infect Dis. 2019 Feb;79:162-168. doi: 10.1016/j.ijid.2018.12.002. Epub 2018 Dec 7.
To compare the molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) isolates between an old, urban hospital and a new, rural hospital over the same time period.
The molecular characteristics of 398 MRSA bloodstream isolates collected between 2007 and 2013 from two hospitals in Taiwan were analyzed retrospectively; 202 isolates were from the old hospital and 196 from the new hospital (opened in 2007).
The rate of resistance to multiple antibiotics was significantly higher in the old hospital (93%) than in the new hospital (81%) (p<0.001). Genetic community-associated MRSA carrying staphylococcal cassette chromosome (SCC) type IV or V accounted for 58% of all MRSA isolates in the new hospital, significantly higher than the rate in the old hospital (p=0.018). The rate of spa t037-SCCmec III MRSA was significantly lower in the new hospital than in the old hospital (p=0.02). A significant decreasing trend in spa t002-SCCmec II MRSA isolates was observed in the old hospital (p=0.006), while the proportion of spa t037-SCCmec III MRSA decreased significantly in the new hospital (41.7% to 26.1%, p=0.022).
The rate of multiple antibiotic resistance and the molecular characteristics of MRSA differed significantly between the old and new hospitals and changed over time.
比较同一时期一家旧的城市医院和一家新的农村医院耐甲氧西林金黄色葡萄球菌（MRSA）分离株的分子流行病学。
回顾性分析了台湾两家医院 2007 年至 2013 年间采集的 398 株 MRSA 血流感染分离株的分子特征；其中 202 株来自旧医院，196 株来自新医院（2007 年开业）。
旧医院（93%）对多种抗生素的耐药率明显高于新医院（81%）（p<0.001）。新型社区相关 MRSA 携带葡萄球菌盒染色体（SCC）IV 或 V 型，占新医院所有 MRSA 分离株的 58%，明显高于旧医院（p=0.018）。新型医院 spa t037-SCCmec III MRSA 的检出率明显低于旧医院（p=0.02）。旧医院 spa t002-SCCmec II MRSA 分离株的检出率呈显著下降趋势（p=0.006），而新医院 spa t037-SCCmec III MRSA 的比例显著下降（41.7%至 26.1%，p=0.022）。
旧医院和新医院之间的多重抗生素耐药率和 MRSA 的分子特征存在显著差异，且随时间推移而变化。
