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首页> 外文期刊>Journal of Clinical Microbiology >Comparison of epidemiological markers used in the investigation of an outbreak of methicillin-resistant Staphylococcus aureus infections.
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Comparison of epidemiological markers used in the investigation of an outbreak of methicillin-resistant Staphylococcus aureus infections.

机译：用于研究耐甲氧西林金黄色葡萄球菌感染暴发的流行病学标记的比较。

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An outbreak of nosocomial infections was caused by a single strain of methicillin-resistant (MR) Staphylococcus aureus. This strain was followed as it was transmitted from the index case to 17 patients, 3 hospital personnel, and 12 items in the hospital environment. The MR S. aureus strain was traced by using four specific epidemiological markers: antibiogram, phage type, production of aminoglycoside-inactivating enzymes, and plasmid pattern. These markers were assessed for their reliability in differentiating the epidemic S. aureus strain from resident nonepidemic strains and for the ease and rapidity with which they determined differences. The epidemic strain was resistant to beta-lactam antibiotics, gentamicin, erythromycin, clindamycin, and rifampin. Resistance to rifampin was the only unique marker in the antibiogram which distinguished the epidemic strain from the indigenous strains, and it was the easiest marker to use for screening isolates from culture surveys. Phage typing was poorly reproducible and did not yield results rapidly enough to be useful for ongoing epidemiology. The epidemic strain produced a unique aminoglycoside-inactivating enzyme (3'-phosphotransferase) which distinguished it from indigenous gentamicin-resistant staphylococci, but this marker was not easily identified, nor was identification helpful during the course of the investigation. Plasmid pattern analysis was rapidly performed (in less than 24 h), allowed many isolates to be examined at a time, was stable and reproducible, and yielded a unique fingerprint which distinguished the epidemic strain from all indigenous isolates. Plasmid pattern analysis is a promising epidemiological tool for MR S. aureus outbreaks in which epidemic strains lack unique antibiotic resistance markers.
机译：一株耐甲氧西林（MR）金黄色葡萄球菌引起的医院感染暴发。该菌株是从指示病例传播到医院环境中的17名患者，3名医院工作人员和12件物品的。通过使用四个特定的流行病学标记物追踪金黄色葡萄球菌菌株：抗菌素，噬菌体类型，氨基糖苷失活酶的产生和质粒模式。评估了这些标记物在区分流行性金黄色葡萄球菌与非流行性流行株中的可靠性以及确定差异的简便性和快速性。该流行株对β-内酰胺类抗生素，庆大霉素，红霉素，克林霉素和利福平有抗药性。对利福平的抗性是抗菌素谱图中唯一将流行株与本地株区分开的唯一标志物，并且它是用于筛选培养物调查菌株的最简单标志物。噬菌体分型的重现性很差，不能足够迅速地得出结果，无法用于正在进行的流行病学研究。该流行病菌株产生了独特的氨基糖苷失活酶（3'-磷酸转移酶），使其与本地的耐庆大霉素的葡萄球菌区别开来，但这种标记不容易鉴定，在研究过程中鉴定也无济于事。质粒模式分析迅速进行（不到24小时），一次可检查许多分离株，稳定且可重现，并产生了独特的指纹，可将流行株与所有本地分离株区分开。质粒模式分析是金黄色葡萄球菌暴发的有前途的流行病学工具，其中流行株缺乏独特的抗生素抗性标记。

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