Mackenzie A, Johnson W, Heyes B, Norrish B, Jamieson F
Department of Laboratory Medicine, Ottawa Civic Hospital, Ontario, Canada.
Diagn Microbiol Infect Dis. 1995 Feb;21(2):69-75. doi: 10.1016/0732-8893(95)00024-5.
An outbreak of erythromycin-resistant, exfoliative toxin-producing Staphylococcus aureus infection in a neonatal unit is described. The organism was coagulase positive but staphyloslide negative, and this unusual phenotype facilitated early recognition of the organism in the routine laboratory. In the initial outbreak there were 77 probable or confirmed cases, with a peak attack rate of 66%. Increased infection control measures were put in place and attempts were made to identify a staff carrier. No carriers were found and the major outbreak subsided. Sporadic cases occurred over the following 10 months, until May 1992, when a colonized staffperson was discovered. She was treated and no further cases occurred. The causative organism was subjected to typing by phage, enterobacterial repetitive intergenic consensus sequence polymerase chain reaction, and pulsed-field gel electrophoresis with two separate enzymes. The phage typing and genomic tests confirmed the presence of the same clone in the unit for 9 months. The organism possessed genes encoding exfoliative toxin A as determined by polymerase chain reaction.
本文描述了新生儿病房中发生的一起由产剥脱毒素的耐红霉素金黄色葡萄球菌感染引发的疫情。该菌株凝固酶阳性，但葡萄球菌玻片试验阴性，这种不寻常的表型有助于在常规实验室中早期识别该菌株。在最初的疫情中，有77例可能或确诊病例，最高发病率为66%。加强了感染控制措施，并试图找出带菌工作人员。未发现带菌者，主要疫情得到缓解。在接下来的10个月里出现了散发病例，直到1992年5月，发现一名带菌工作人员。她接受了治疗，此后未再出现病例。通过噬菌体分型、肠杆菌重复基因间共识序列聚合酶链反应以及用两种不同酶进行的脉冲场凝胶电泳对病原体进行分型。噬菌体分型和基因组检测证实该病房在9个月内存在相同克隆。通过聚合酶链反应确定该菌株具有编码剥脱毒素A的基因。
