烧伤病房内MRSA传播途径的IRS-PCR分析

目的:分析阐明某一医院烧伤科同一病房同一时期内不同患者MRSA感染的可能途径及分子流行病学特征。方法:将从不同患者烧伤创面、医护人员的手、工作服及其他环境表面分离的MRSA进行抗生素敏感性表型及IRS-PCR分析。结果:患者感染的MRSA与环境中存在的MRSA均对呋喃妥因、万古霉素敏感,在耐药性方面无显著差异。而IRS-PCR分析则显示,医生的手携带的MRSA与该病房内三位患者感染的MRSA高度同源,相似性系数在85%以上。结论:不同患者烧伤创面MRSA的感染极有可能是通过医生的手传播的。IRS-PCR是一种适宜于临床MRSA感染分析的灵敏性高、分辨率强、重复型好的分子流行病学研究工具;加强医护人员的感染控制观念,开展MRSA的分子流行病学监控对有效降低MRSA感染率至关重要。

IRS-PCR fingerprint of MRSA transmission among patients in a burn ward

Objective: to disseminate the possible transmission pathway of MRSA(methicillin-resistant staphylococcus aureus) between patients during a outbreak in a burn ward.Methods:we investigated the antimicrobial susceptibilities and IRS-PCR(infrequent restriction site-PCR) patterns of 6 MRSAs,which were isolated from the burn wound of patients,hands of doctor and nurse,other environmental surface in this ward,respectively.Results: It was demonstrated that all clinical and environmental MRSAs had no significant difference in susceptibility to 16 kinds of antibiotics and susceptible to Nitrofurantoin and Vancomycin.Nevertheless,the IRS-PCR patterns showed that MRSA from patients shared very high similarity(>85%) with MRSA from the doctor's hand but had less similarity with other MRSAs.Conclusion:The results suggested It is strongly evident that the MRSAs from different patients in this burn unit was transmitted through the doctor's hand.IRS-PCR is a sensitive and reproducible tool with high discrimination power for epidemiological study on MRSA infection.Enhancement of infection control measures,like hand hygiene,is essential to reduce the incidence of MRSA infection.