临床实验室和分子流行病学对MRSA疫情调查的重要性。

Keiji Kanemitsu, Kiwamu Nakamura
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引用次数: 0

摘要

耐甲氧西林金黄色葡萄球菌是院内爆发的主要病原体。此外,即使在日本医院,社区获得性MRSA(CA-MRSA)的分离也在增加。有必要与临床实验室合作开展疫情调查,因为临床实验室是发现MRSA的场所。“从临床实验室获得MRSA信息的时机”对ICT至关重要。为了发现爆发的迹象,每周或每月每个病房的MRSA分离株数量信息是必不可少的。定期进行主动监视是可取的。然而,主动监测的成本、实验室技术人员的工作量以及隔离室的短缺等问题仍有待解决。感染控制部门有必要通过分子流行病学分析,包括基于pcr的开放阅读框分型(POT)方法,确认克隆传播。当某病房MRSA分离株数量增加且部分菌株具有相同的POT数时,我们怀疑发生了MRSA疫情,加强了感染控制措施。我们在此描述与临床实验室的关系的重要性感染控制和如何控制MRSA爆发迅速。(审查)。
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[Importance of Clinical Laboratory and Molecular Epidemiology for Investigation of MRSA Outbreak].

MRSA has been a major pathogen associated with nosocomial outbreaks. Moreover, the isolation of community-acquired MRSA(CA-MRSA) is increasing even in Japanese hospitals. It is necessary to carry out outbreak investigations in cooperation with the clinical laboratory as it is the site where MRSA is identi- fied. "Timing of information on MRSA from the clinical laboratory" is crucial for the ICT. To detect signs of an outbreak, information on the number of MRSA isolates is essential in every ward per week or month. It is desirable to perform active surveillance routinely. However, there are problems to be solved such as the cost of active surveillance, workload of laboratory technicians, and shortage of private rooms for isolation. It is necessary that the infection control department confirms clonal spread on analysis of the molecular epi- demiology, including the PCR-based open reading frame typing (POT) method. When the number of MRSA isolates increased and some strains had the same POT number on a ward, we suspected MRSA outbreak and strengthened infection control measures. We describe herein the importance of the relationship with the clinical laboratory for infection control and how to control an MRSA outbreak rapidly. [Review].

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