Molecular Epidemiology and Control of Nosocomial Methicillin-Resistant Staphylococcus Aureus Infection in a Teaching Hospital

一教學醫院院內methicillin抗藥性金黃色葡萄球菌感染之分子流行病學與控制

王振泰(Jann-Tay Wang) ； 林昇鋒(Sheng-Fong Lin) ； 邱淑玲(Hsu-Ling Chiu) ； 王麗珍(Li-Chen Wang) ； 戴惠敏(Hui-Ming Tai) ； 江兆豐(Chaw-Fung Jiang) ； 張上淳(Shan-Chwen Chang) ； 朱樹勳(Shu-Hsun Chu)

《Journal of the Formosan Medical Association》 103卷1期 (2004/01) Pp. 32-36

https://doi.org/10.29828/JFMA.200401.0005

並列摘要

Background and Purpose: Nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection is difficult to control. Due to a dramatic increase in the nosocomial MRSA infection rate at our hospital from 2000 to 2001, this study was conducted to identify the source of these infections and the effectiveness of control measures.
Methods: 179 healthcare workers (HCWs) were screened for carriage of MRSA. Starting in April 2001, all patients with MRSA infection or colonization were put in strict contact and cohort isolation. The bacterial isolates of HCW carriers and patients with MRSA infection from April 2001 to September 2001 were subjected to antimicrobial susceptibility testing by disk-diffusion method and molecular typing by pulsed-field gel electrophoresis (PFGE).
Results: Fifteen HCWs were found to be carriers of MRSA. They were all given topical mupirocin treatment. After these interventions, the nosocomial MRSA infection rate decreased from 1.23 to 0.53 per 1000 patient-days. All 61 MRSA isolates available for antimicrobial susceptibility testing and molecular typing were multidrug resistant. PFGE study revealed 2 predominant types, type C and type Y, comprising 36 and 12 isolates, respectively.
Conclusions: The current study demonstrates the importance of measures to control nosocomial MRSA infections in hospitals that already have a high incidence of endemic MRSA infection. Elimination of carriage by healthcare workers, and strict contact and cohort isolation are the main effective measures.

並列關鍵字

Cross infection ； Infection control ； Methicillin resistance ； Staphylococcal infections ； Taiwan