Law M R, Gill O N
Department of Environmental and Preventive Medicine, Medical College of St Bartholomew's Hospital, London.
Epidemiol Infect. 1988 Dec;101(3):623-9. doi: 10.1017/s0950268800029496.
In-patients at a London hospital over one year from whom the south-east England strain of 'epidemic' methicillin-resistant Staphylococcus aureus (MRSA) was isolated were compared with in-patients with strains of methicillin-sensitive Staphylococcus aureus (MSSA). MRSA were virtually entirely hospital-acquired; isolates before 10 days were uncommon and related to recent previous admission. Thereafter first isolates occurred at a fairly constant daily rate of about 1.9 per 1,000 in-patients. Acquisition of MSSA after more than 4 days in hospital occurred at a similar constant rate. Such strains were less likely to be penicillin-sensitive than strains isolated in the first 4 days after admission (11 vs. 22%) and were considered to be hospital-acquired. The single MRSA strain caused 40 infections in a year, about half of all hospital-acquired staphylococcal infections. Patients prescribed anti-staphylococcal antibiotics and patients with indwelling cannulae both had about a ninefold increased risk of acquiring MRSA. There was no reciprocal increase in MSSA infections after control measures had substantially reduced the number of MRSA infections.
对伦敦一家医院一年内分离出英格兰东南部“流行”的耐甲氧西林金黄色葡萄球菌（MRSA）菌株的住院患者与分离出甲氧西林敏感金黄色葡萄球菌（MSSA）菌株的住院患者进行了比较。MRSA几乎完全是医院获得性的；入院10天前分离出的菌株并不常见，且与近期入院有关。此后，首批分离菌株以相当稳定的每日发生率出现，每1000名住院患者中约有1.9例。住院4天以上后获得MSSA的发生率也类似且稳定。与入院后前4天分离出的菌株相比，这些菌株对青霉素敏感的可能性较小（分别为11%和22%），并被认为是医院获得性的。单一的MRSA菌株在一年内导致了40起感染，约占所有医院获得性葡萄球菌感染的一半。使用抗葡萄球菌抗生素的患者和留置套管的患者获得MRSA的风险均增加了约9倍。在控制措施大幅减少MRSA感染数量后，MSSA感染并未相应增加。
