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乌克兰基辅耳鼻喉科和牙科部门医护人员中耐甲氧西林金黄色葡萄球菌鼻腔携带率的研究

PREVALENCE OF NASAL CARRIAGE OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS AMONG HEALTHCARE WORKERS IN THE DEPARTMENTS OF OTORINOLARYNGOLOGY AND DENTISTRY IN KYIV, UKRAINE.

机构信息

SHUPYK NATIONAL MEDICAL ACADEMY OF POSTGRADUATE EDUCATION, KYIV, UKRAINE.

BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE.

出版信息

Wiad Lek. 2020;73(12 cz 1):2563-2567.

Abstract

OBJECTIVE

The aim: To obtain the first estimates of the current prevalence of nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) among healthcare workers (HCWs) in the departments of Otorinolaryngology and Dentistry and to determine of genes virulence factors (Panton Valentine Leukocidine (PVL) genes).

PATIENTS AND METHODS

Materials and methods: We performed a multicenter cross-sectional study. The susceptibility to antibiotics was determined by disk diffusion method according to the European Committee on Antimicrobial Susceptibility Testing. The virulence factor encoding genes, mecA, lukS-lukF, were detected by Polymerase Chain Reaction (PCR).

RESULTS

Results: Incidence rate of S. aureus nasal carriage among HCWs was 36.2%, whereas MRSA carriage was 17%. Prevalence of MRSA carriage rate was 34.9% in Otorhinolaryngology departments and 9.7% in Dentistry. PCR testing confirmed that all MRSA strains were mecA gene-positive. The virulence factor encoding genes were detected in 82.3% of the S. aureus isolates from HCWs. Among S.aureus, the lukS-lukF genes were detected in over 59% of the strains. The lukS-lukF genes were detected in 55.5% of MRSA and in 58.9% of MSSA strains. LukS-lukF genes were most commonly co-present in MRSA strains. No significant difference was detected between the occurrences of lukS-lukF genes (P > 0.05).

CONCLUSION

Conclusions: Personnell in otorhinolaryngology and dentistry departments have a high rate of nasal colonization of MRSA. This carrier state may be an important risk factor for transmission MRSA from physicians and nurses to patients and vice-versa. Screening for MRSA nasal carriage of HCWs is a key element in enabling infection control measures and early therapeutic decisions.

摘要

目的

获得耳鼻喉科和牙科医护人员(HCWs)中耐甲氧西林金黄色葡萄球菌(MRSA)鼻腔携带率的最新估计值,并确定毒力因子基因(杀白细胞素 Panton-Valentine (PVL)基因)。

患者和方法

我们进行了一项多中心横断面研究。抗生素敏感性通过纸片扩散法根据欧洲抗菌药物敏感性试验委员会确定。通过聚合酶链反应(PCR)检测编码毒力因子的 mecA、lukS-lukF 基因。

结果

HCWs 中金黄色葡萄球菌鼻腔携带率为 36.2%,而 MRSA 携带率为 17%。耳鼻喉科部门的 MRSA 携带率为 34.9%,牙科部门为 9.7%。PCR 检测证实所有 MRSA 菌株均为 mecA 基因阳性。在 82.3%的 HCWs 金黄色葡萄球菌分离株中检测到编码毒力因子的基因。在金黄色葡萄球菌中,lukS-lukF 基因在超过 59%的菌株中被检测到。MRSA 和 MSSA 菌株中均检测到 lukS-lukF 基因,分别为 55.5%和 58.9%。lukS-lukF 基因最常共同存在于 MRSA 菌株中。lukS-lukF 基因的存在没有差异(P>0.05)。

结论

耳鼻喉科和牙科部门的人员鼻腔携带 MRSA 的比例很高。这种携带状态可能是医生和护士将 MRSA 传播给患者,反之亦然的重要危险因素。筛查 HCWs 的 MRSA 鼻腔携带情况是实施感染控制措施和早期治疗决策的关键要素。

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