Brodíková Kristýna, Rezková Bohdana, Koláčková Ivana, Karpíšková Renáta
Department of Public Health, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic.
Folia Microbiol (Praha). 2025 Feb;70(1):241-248. doi: 10.1007/s12223-024-01237-1. Epub 2025 Jan 13.
Medical students are exposed to the hospital environment and patients during their studies, increasing the risk of exposure to virulent and antibiotic-resistant isolates of Staphylococcus aureus. The aim of the study is to determine the prevalence of Staphylococcus aureus among medical students who have varying levels of exposure to the hospital environment to provide valuable insights into the risk of colonization and transmission. Nasal swabs and fingerprints were obtained and cultured on a selective medium for staphylococci. The obtained isolates were confirmed as methicillin-sensitive S. aureus (MSSA) or methicillin-resistant (MRSA) using PCR. Antibiotic resistance, the presence of virulence genes including enterotoxin encoding genes, and spa typing were performed. Among pre-clinical students, MSSA was detected on the nose in 45.2% and on the fingerprints in 10.6% of the participants. Among clinical students, MSSA was detected on the nose in 42.0% and on the fingerprints in 25.4%. Only one MRSA isolate was obtained. Genes seg and sei were the most frequently detected in both student groups, with their presence in over 40% of isolates among clinical students. The eta and etb genes were mainly detected from the nose in both student groups. In pre-clinical students, S. aureus carrying eta gene occurred in 6.4% and etb in 8.5%. In clinical students, the occurrence was 5.1% for eta and 8.5% for etb. The tst gene was identified only in the nose and fingerprints of the clinical student group. The most frequently observed resistance was to clindamycin and erythromycin. In total 58 different spa types were identified. High rates of asymptomatic MSSA carriage were observed in both groups of medical students. Detected MSSA strains showed a high degree of genetic variability, with a number of them carrying the virulence and antibiotic resistance genes. Although students do not exhibit increased risk to their patient's, increased hygiene is required in asymptomatic carriage personnel. The overall prevalence of MRSA was low, with a minimal risk of spread.
医学生在学习期间会接触医院环境和患者，这增加了他们接触毒性强且耐抗生素的金黄色葡萄球菌菌株的风险。本研究的目的是确定不同程度接触医院环境的医学生中金黄色葡萄球菌的流行情况，以便深入了解定植和传播风险。采集鼻拭子和指纹样本，并在葡萄球菌选择性培养基上进行培养。使用聚合酶链反应（PCR）将获得的分离株确认为甲氧西林敏感金黄色葡萄球菌（MSSA）或耐甲氧西林金黄色葡萄球菌（MRSA）。检测抗生素耐药性、包括肠毒素编码基因在内的毒力基因的存在情况以及spa分型。在临床前学生中，45.2%的参与者鼻部分离出MSSA，10.6%的参与者指纹中分离出MSSA。在临床学生中，42.0%的参与者鼻部分离出MSSA，25.4%的参与者指纹中分离出MSSA。仅获得一株MRSA分离株。seg和sei基因在两个学生组中检测频率最高，在临床学生中超过40%的分离株中存在。eta和etb基因主要在两个学生组的鼻部分离株中检测到。在临床前学生中，携带eta基因的金黄色葡萄球菌发生率为6.4%，携带etb基因的为8.5%。在临床学生中，eta基因的发生率为5.1%，etb基因的为8.5%。tst基因仅在临床学生组的鼻拭子和指纹中被鉴定出。最常观察到的耐药性是对克林霉素和红霉素。总共鉴定出58种不同的spa分型。两组医学生中均观察到无症状MSSA携带率较高。检测到的MSSA菌株显示出高度的遗传变异性，其中许多携带毒力和抗生素耐药基因。虽然学生对患者没有表现出更高的风险，但无症状携带者需要加强卫生管理。MRSA的总体流行率较低，传播风险极小。
