Möllers Mareike, von Wahlde Marie-Kristin, Schuler Franziska, Mellmann Alexander, Böing Christian, Schwierzeck Vera, Schneider Julia Sophie, Kampmeier Stefanie
Department of Obstetrics and Gynecology, University Hospital Münster, 48149 Münster, Germany.
Institute of Medical Microbiology, University Hospital Münster, 48149 Münster, Germany.
Microorganisms. 2022 Mar 23;10(4):689. doi: 10.3390/microorganisms10040689.
Since March 2020, the COVID-19 pandemic forced hospitals worldwide to intensify their infection control measures to prevent health care-associated transmission of SARS-CoV-2. The correct use of personal protective equipment, especially the application of masks, was quickly identified as priority to reduce transmission with this pathogen. Here, we report a nosocomial cluster of methicillin-resistant (MRSA) that occurred during the COVID-19 pandemic in a gynecology/obstetrics department, despite these intensified contact precautions. Five MRSA originating from clinical samples after surgical intervention led to an outbreak investigation. Firstly, this included environmental sampling of the operation theatre (OT) and, secondly, a point prevalence screening of patients and health care workers (HCW). All detected MRSA were subjected to whole genome sequencing (WGS) and isolate relatedness was determined using core genome multilocus sequence typing (cgMLST). WGS revealed one MRSA cluster with genetically closely related five patient and two HCW isolates differing in a single cgMLST allele at maximum. The outbreak was terminated after implementation of infection control bundle strategies. Although contact precaution measures, which are also part of MRSA prevention bundle strategies, were intensified during the COVID-19 pandemic, this MRSA outbreak could take place. This illustrates the importance of adherence to classical infection prevention strategies.
自2020年3月以来，新冠疫情迫使全球医院加强感染控制措施，以防止严重急性呼吸综合征冠状病毒2（SARS-CoV-2）在医疗环境中的传播。正确使用个人防护装备，尤其是口罩的佩戴，很快被确定为减少该病原体传播的首要任务。在此，我们报告了在新冠疫情期间，某妇产科发生的一起耐甲氧西林金黄色葡萄球菌（MRSA）医院感染聚集性病例，尽管已经加强了接触预防措施。手术干预后从临床样本中分离出的5株MRSA引发了一次疫情调查。首先，对手术室（OT）进行了环境采样，其次，对患者和医护人员（HCW）进行了现患率筛查。所有检测到的MRSA均进行了全基因组测序（WGS），并使用核心基因组多位点序列分型（cgMLST）确定菌株的亲缘关系。WGS显示存在一个MRSA聚集性病例，其中5株患者分离株和2株医护人员分离株在基因上密切相关，最多相差一个cgMLST等位基因。在实施感染控制综合策略后，疫情得到了控制。尽管在新冠疫情期间加强了接触预防措施（这也是MRSA预防综合策略的一部分），但仍发生了此次MRSA疫情。这说明了坚持经典感染预防策略的重要性。
