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鹿岛罗萨医院葡萄球菌感染事件分析(一)

[An analysis of incidents of Staphylococcus in Kashima Rosai Hospital (I)].

作者信息

Tomizawa K, Sato S

机构信息

Department of Medicament, Kashima Rosai Hospital.

出版信息

Jpn J Antibiot. 1988 May;41(5):494-504.

PMID:3216472
Abstract

Isolation patterns and drug susceptibilities of Staphylococcus aureus and Staphylococcus epidermidis were investigated in Kashima Rosai Hospital, a local hospital with 300 beds opened in June, 1981. Our investigation covered 218 Staphylococcus strains isolated from various clinical materials in the Clinical Laboratory during a one year period in 1985. These isolated strains comprised of 8 species of genus Staphylococcus with S. aureus and S. epidermidis together accounted for 93.6% of all the clinically isolated Staphylococci. S. aureus was depicted in materials obtained from outpatients at a higher frequency than S. epidermidis, while the opposite was the case in materials obtained from inpatients. When distribution of these organisms were classified depending on clinical materials from which they were isolated, outpatient sources from which S. aureus were isolated at high frequencies were otorrhea and pus, while inpatient sources with high incidents of S. aureus isolation were sputum and pus. With regards to S. epidermidis, urine and pus from outpatients as well as from inpatients yielded this organism at high frequencies. Isolation frequency ratios in this hospital of methicillin-resistant S. aureus (MRSA) and S. epidermidis (MRSE) were 8.6% and 30.*%, respectively. These resistant strains were found from a large spectrum of clinical materials. Thus, these strains seemed to have established themselves more or less firmly among bacterial population in the hospital, hence alerting us the risk of hospital infections in compromised hosts. As to the coagulase typing of MRSA, type IV was the most frequent from outpatient sources whereas type II was the most frequent from inpatient sources including a large variety of clinical materials. The coagulase typing has been and rapid than the phage typing. We confirmed these in our investigation. Among beta-lactam antibiotics we tested against MRSA, flomoxef was found to be superior to the others. Cephalothin and cefamandole proved to be highly active against MRSE. Minocycline and vancomycin showed good activities against MRSE as well as MRSA.

摘要

1981年6月开业的拥有300张床位的当地医院鹿岛罗萨伊医院,对金黄色葡萄球菌和表皮葡萄球菌的分离模式及药敏情况进行了调查。我们的调查涵盖了1985年临床实验室在一年时间里从各种临床材料中分离出的218株葡萄球菌菌株。这些分离菌株包括葡萄球菌属的8个种,其中金黄色葡萄球菌和表皮葡萄球菌共占所有临床分离葡萄球菌的93.6%。从门诊患者获得的材料中,金黄色葡萄球菌的检出频率高于表皮葡萄球菌,而在从住院患者获得的材料中情况则相反。当根据分离出这些微生物的临床材料对其分布进行分类时,门诊来源中金黄色葡萄球菌分离频率较高的是耳漏和脓液,而住院来源中金黄色葡萄球菌分离率较高的是痰液和脓液。至于表皮葡萄球菌,门诊和住院患者的尿液和脓液中该菌的检出频率都很高。该医院耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林表皮葡萄球菌(MRSE)的分离频率分别为8.6%和30.*%。这些耐药菌株在大量临床材料中被发现。因此,这些菌株似乎在医院的细菌群体中或多或少地稳固存在,这提醒我们免疫功能低下宿主存在医院感染的风险。至于MRSA的凝固酶分型,IV型在门诊来源中最为常见,而II型在包括多种临床材料的住院来源中最为常见。凝固酶分型比噬菌体分型更快。我们在调查中证实了这一点。在我们针对MRSA测试的β-内酰胺类抗生素中,氟氧头孢被发现优于其他药物。头孢噻吩和头孢孟多对MRSE具有高度活性。米诺环素和万古霉素对MRSE以及MRSA均显示出良好活性。

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