Tobita M, Kobayashi N, Hirasawa H, Konno K, Urayama O, Nakagomi O, Miura A, Uesugi S
Clinical Laboratory, Akita University Hospital.
Rinsho Byori. 1996 Apr;44(4):367-72.
In order to control the nosocomial infections by methicillin-resistant Staphylococcus aureus (MRSA) in the Akita University Hospital, the systematic surveillance for MRSA-infection has been done since October in 1991. We reviewed MRSA-isolation numbers, MRSA-detected patient numbers, risk factors of nosocomial infection and patient's basic diseases with the data of a total 336 cases, and then examined the microbiological characteristics of MRSA strains which had been isolated in our hospital in 1986 approximately 1994. The results obtained are as follows; 1) MRSAs were isolated at 13 per month on the average and the detection rate was 0.81 to 1,000 inpatients per day. 2) MRSAs were isolated more in the surgical ward. 3) Patients with 0 year old and more than 60 years old were more infected. 4) MRSA was isolated more from the immunocompromised patients with underlying diseases such as malignant tumors but half of the diseases were not affected by MRSA. 5) Seventy percent of patients had the risk factors of MRSA-transmission such as surgical operation and IVH-cathetering. 6) All isolates of MRSA strains in our hospital showed type II in coagulase type analysis and resistance to minocycline and ofloxacin. 7) It was suggested that one strain expanded throughout the hospital by several DNA analysis with the mecA gene in MRSA. These surveillance and microbiology data will be useful for our nosocomial mecA gene in MRSA. These surveillance and microbiology data will be useful for our nosocomial infection control.
为控制秋田大学医院耐甲氧西林金黄色葡萄球菌(MRSA)引起的医院感染,自1991年10月起对MRSA感染进行了系统监测。我们回顾了336例患者的MRSA分离数、MRSA检测患者数、医院感染危险因素及患者基础疾病,并对我院1986年至1994年分离的MRSA菌株的微生物学特征进行了研究。结果如下:1)平均每月分离出13株MRSA,检出率为每1000名住院患者中有0.81株。2)外科病房分离出的MRSA更多。3)0岁和60岁以上的患者感染更多。4)MRSA更多地从患有恶性肿瘤等基础疾病的免疫功能低下患者中分离出来,但一半的疾病不受MRSA影响。5)70%的患者有MRSA传播的危险因素,如手术和静脉内导管插入术。6)我院所有MRSA菌株分离株在凝固酶类型分析中均显示为II型,对米诺环素和氧氟沙星耐药。7)通过对MRSA中mecA基因的多次DNA分析表明,有一种菌株在全院传播。这些监测和微生物学数据将有助于我们控制医院内MRSA的感染。