Riley T V, Rouse I L
Health Services Statistics and Epidemiology Branch, Health Department of Western Australia, East Perth.
J Hosp Infect. 1995 Mar;29(3):177-88. doi: 10.1016/0195-6701(95)90327-5.
A statewide screening programme has prevented imported strains of methicillin-resistant Staphylococcus aureus (MRSA) from becoming established in any hospital in Western Australia (WA). Recently, notifications of MRSA in WA have increased, prompting a review of surveillance data for the period 1983-1992. Our aims were to determine: (i) the distribution by age and sex of persons with MRSA; (ii) changes in notification rates over time and by location in WA; and (iii) temporal changes in antimicrobial resistance patterns. There were 631 notifications of MRSA for the 10 year period 1983-1992, ranging from a low of 36 in 1988 to a high of 117 in 1992. When the distribution by age and sex was examined, three age group peaks were apparent: 0-9 years, 20-39 years and 60-79 years. There was a predominance of females in the 20-39 years age group, reflecting a greater proportion of hospital nursing staff carrying MRSA. In those aged 50 years or more, there was a marked predominance of males. The highest notification rates overall occurred in the remote Kimberley region of WA, however, rates increased significantly in all regions of the state in 1992. Based on antimicrobial resistance patterns, MRSA was classified into two groups: multiresistant imported strains which often caused outbreaks in hospitals; and a less resistant MRSA (WA MRSA). WA MRSA appears to have originated in the Kimberley region and then spread widely in the community to other regions of the state, and the proportion of WA MRSA has increased significantly since 1989.
一项全州范围的筛查计划成功阻止了耐甲氧西林金黄色葡萄球菌（MRSA）的输入菌株在西澳大利亚州（WA）的任何一家医院中定植。最近，WA地区MRSA的报告数量有所增加，促使对1983 - 1992年期间的监测数据进行审查。我们的目的是确定：（i）MRSA感染者的年龄和性别分布；（ii）WA地区随时间推移以及不同地点报告率的变化；（iii）抗菌药物耐药模式的时间变化。在1983 - 1992年的10年期间，共有631例MRSA报告，数量从1988年的低点36例到1992年的高点117例不等。在检查年龄和性别分布时，出现了三个年龄组高峰：0 - 9岁、20 - 39岁和60 - 79岁。在20 - 39岁年龄组中女性占主导，这反映出携带MRSA的医院护理人员比例更高。在50岁及以上人群中，男性明显占主导。总体而言，报告率最高的是WA偏远的金伯利地区，不过，1992年该州所有地区的报告率都显著上升。根据抗菌药物耐药模式，MRSA被分为两组：多耐药输入菌株，这类菌株常在医院引发疫情；以及耐药性较低的MRSA（WA MRSA）。WA MRSA似乎起源于金伯利地区，然后在社区中广泛传播至该州的其他地区，自1989年以来，WA MRSA的比例显著增加。
