金黄色葡萄球菌:与MRSA特别相关的医护人员和住院患者的鼻腔携带

P. Maroof, R. Nasir, N. Bali, Anjum Farhana, M. Amin, Farhath Kanth
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引用次数: 3

摘要

目的:了解某三级保健中心医护人员及住院病人的鼻腔携带金黄色葡萄球菌情况。研究设计:横断面研究。方法:从卫生保健工作者(HCWs)和住院患者中采集鼻拭子,并对其进行处理,以回收金黄色葡萄球菌(金黄色葡萄球菌)和耐甲氧西林金黄色葡萄球菌(MRSA)。根据临床实验室标准协会(CLSI)、指南和d试验确定大环内酯-lincosamide-streptogramin B (cMLS B)组成型和诱导型大环内酯-lincosamide-streptogramin B (i MLS B)表型,对各菌株进行了抗生素敏感性测定。并分析了其携带的危险因素。采用SPSS软件16版进行统计学分析,P值< 0.05为差异有统计学意义。结果480例住院患者中金黄色葡萄球菌和MRSA的分离率分别为47.1%和32.7%,高于256例普通医护人员(32.8%和19.1%)。住院患者MRSA分离株对克林霉素、红霉素、环丙沙星、四环素和复方新诺明均有显著耐药(P<0.05)。MRSA分离株具有较高的cMLS B和imls B耐药性。医护人员的服务年限和教育水平与MRSA携带显著相关。结论:我院医护人员及住院患者鼻腔携带金黄色葡萄球菌和MRSA较为常见。除了定期筛查耐甲氧西林金黄色葡萄球菌携带外,还必须严格遵守现有的感染控制指南。
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Staphylococcus aureus: Nasal-carriage in Health Care Workers and In-patients with Special Reference to MRSA
Aims: To find out the nasal carriage of Staphylococcus aureus in health care workers and in-patients in a tertiary care center. Study Design: Cross sectional study. year study 2013 Methodology: Nasal swabs were taken from health care workers (HCWs) and in-patients and these were processed for the recovery of Staphylococcus aureus ( S. aureus ) and methicillin resistant Staphylococcus aureus (MRSA). Antimicrobial susceptibility of the isolates to various antibiotics was performed as per Clinical Laboratory Standards Institute (CLSI), guidelines and D-test done to ascertain constitutive macrolide-lincosamide-streptogramin B (cMLS B ) and inducible macrolide-lincosamide-streptogramin B ( i MLS B ) phenotype. Risk factors for their carriage were also analyzed. Statistical analysis was done using SPSS software version 16 and a P value of < 0.05 was taken as significant. Results: Higher rate of isolation of S. aureus and MRSA was seen among 480 in-patients (47.1% and 32.7% respectively) compared with 256 HCWs (32.8% and 19.1% respectively). Significant resistance (P<0.05) to clindamycin, erythromycin, ciprofloxacin, tetracycline and co-trimoxazole was seen in MRSA isolates recovered from in-patients. MRSA isolates had higher cMLS B and i MLS B resistance. Years of service and level of education in HCWs were significantly associated with MRSA carriage in them. Conclusion: Nasal-carriage of S. aureus and MRSA is common in HCWs and in-patients in our hospital. Apart from periodic screening for MRSA carriage, strict adherence to existing infection control guidelines is mandatory.
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