研究人员发现医务人员鼻腔中高MRSA携带率！！！
警戒：研究人员发现医务人员鼻腔中高MRSA携带率！！！
翻译：朱敬蕊撰写：陈志锦审核：高珊、陈志锦 金黄色葡萄球菌在自然界中无处不在，空气、水、灰尘及人和动物的排泄物中都可找到。美国疾病控制中心报告，由金黄色葡萄球菌引起的感染占第二位，仅次于大肠杆菌。 金黄色葡萄球菌既是社区获得性肺炎（CAP），又是医院获得性肺炎（HAP）的主要致病菌。金黄色葡萄球菌及其他厌氧菌为慢性鼻窦炎的主要感染菌种，医院医务人员鼻腔携带金黄色葡萄球菌是医院获得性感染的常见原因，且其控制难度较大，已经越来越受到医疗机构的重视。 耐药菌株，尤其是耐甲氧西林金黄色葡萄球菌（MRSA）的出现是医院环境中的严重问题。因此， El Aila等人的研究目的是确定加沙地带主要医院Al Shifa医院中，医务人员鼻腔中金黄色葡萄球菌和MRSA的携带率。该研究对200名医务人员进行了横断面研究。在2015年2月至4月期间收集鼻拭子，并在血液和甘露醇盐琼脂平板上进行培养。基于形态学，凝固酶试验，DNase试验和甘露醇盐琼脂发酵，将分离物鉴定为金黄色葡萄球菌。根据临床和实验室标准协会的指南进行纸片扩散药敏试验。 MRSA则通过PCR检测mecA基因确定。在200名医务人员中，金黄色葡萄球菌携带率高达31%（62名），其中82.3%（51名）是MRSA。因此，25.5％的医务人员被确定为MRSA携带者。在通过苯唑西林盘耐药鉴定的51个MRSA分离菌株中，有40个通过了靶向mecA基因的PCR证实。 青霉素在MRSA和MSSA分离菌株中显现出最高的耐药率，均为100％。从职业来看：MRSA携带率最高的是护士（30.4%），而医生的携带率是16%。从科室来看：MRSA携带者主要为内外科病房的医务人员，携带率分别为41.3和35％。在这项研究中发现的医务人员鼻腔中耐甲氧西林金黄色葡萄球菌(MRSA）的高携带率着实令人担忧，因此，更应强调感染控制措施的落实与改进，以防止 MRSA通过医务人员传播给易感患者。
原文Investigators Find High Rate of Nasal MRSA Carriage Among HCWsNasal carriage of Staphylococcus aureus among hospital personnel is a common cause of hospital acquired infections. Emergence of drug resistant strains especially methicillin-resistant S. aureus (MRSA) is a serious problem in hospital environment. Therefore, the aim of this study by El Aila, et al. (2017) was to determine the nasal carriage rate of S. aureus and MRSA among healthcare workers (HCWs) at Al Shifa Hospital, the major hospital in the Gaza Strip. A cross sectional study was conducted on 200 HCWs. Nasal swabs were collected during February through April 2015, and cultured on blood and mannitol salt agar. The isolates were identified as S. aureus based on morphology, coagulase test, DNase test and mannitol salt agar fermentation. Disk diffusion antibiotic susceptibility tests were performed according to the guidelines of the Clinical and Laboratory Standards Institute. MRSA were confirmed by detection of the mecA gene by PCR. Out of the 200 healthcare workers, 62 (31%) carried S. aureus, of which 51 (82.3%) were MRSA. Therefore, 25.5% of all HCWs were identified as MRSA carriers. MRSA carriage rate was highest among nurses (30.4%) whereas the carriage rate among doctors was (16%). The majority of MRSA carriers were workers of internal medicine department and surgical wards (41.3 and 35% respectively). Out of the 51 MRSA isolates identified by oxacillin disc resistance, 40 were confirmed by PCR targeting the mecA gene. Penicillin showed the highest rate of resistance among MRSA and MSSA isolates (100%). The high rate of nasal MRSA carriage among healthcare workers found in this study is alarming and highlights the need for adjusted infection control measures to prevent MRSA transmission from HCWs to the vulnerable patient.Reference: El Aila NA, et al. Nasal carriage of methicillin resistant Staphylococcus aureus among healthcare workers at Al Shifa hospital in Gaza Strip. BMC Infectious Diseases. 2017;17:28
翻译：朱敬蕊撰写：陈志锦审核：高珊、陈志锦 金黄色葡萄球菌在自然界中无处不在，空气、水、灰尘及人和动物的排泄物中都可找到。美国疾病控制中心报告，由金黄色葡萄球菌引起的感染占第二位，仅次于大肠杆菌。 金黄色葡萄球菌既是社区获得性肺炎（CAP），又是医院获得性肺炎（HAP）的主要致病菌。金黄色葡萄球菌及其他厌氧菌为慢性鼻窦炎的主要感染菌种，医院医务人员鼻腔携带金黄色葡萄球菌是医院获得性感染的常见原因，且其控制难度较大，已经越来越受到医疗机构的重视。 耐药菌株，尤其是耐甲氧西林金黄色葡萄球菌（MRSA）的出现是医院环境中的严重问题。因此， El Aila等人的研究目的是确定加沙地带主要医院Al Shifa医院中，医务人员鼻腔中金黄色葡萄球菌和MRSA的携带率。该研究对200名医务人员进行了横断面研究。在2015年2月至4月期间收集鼻拭子，并在血液和甘露醇盐琼脂平板上进行培养。基于形态学，凝固酶试验，DNase试验和甘露醇盐琼脂发酵，将分离物鉴定为金黄色葡萄球菌。根据临床和实验室标准协会的指南进行纸片扩散药敏试验。 MRSA则通过PCR检测mecA基因确定。在200名医务人员中，金黄色葡萄球菌携带率高达31%（62名），其中82.3%（51名）是MRSA。因此，25.5％的医务人员被确定为MRSA携带者。在通过苯唑西林盘耐药鉴定的51个MRSA分离菌株中，有40个通过了靶向mecA基因的PCR证实。 青霉素在MRSA和MSSA分离菌株中显现出最高的耐药率，均为100％。从职业来看：MRSA携带率最高的是护士（30.4%），而医生的携带率是16%。从科室来看：MRSA携带者主要为内外科病房的医务人员，携带率分别为41.3和35％。在这项研究中发现的医务人员鼻腔中耐甲氧西林金黄色葡萄球菌(MRSA）的高携带率着实令人担忧，因此，更应强调感染控制措施的落实与改进，以防止 MRSA通过医务人员传播给易感患者。
原文Investigators Find High Rate of Nasal MRSA Carriage Among HCWsNasal carriage of Staphylococcus aureus among hospital personnel is a common cause of hospital acquired infections. Emergence of drug resistant strains especially methicillin-resistant S. aureus (MRSA) is a serious problem in hospital environment. Therefore, the aim of this study by El Aila, et al. (2017) was to determine the nasal carriage rate of S. aureus and MRSA among healthcare workers (HCWs) at Al Shifa Hospital, the major hospital in the Gaza Strip. A cross sectional study was conducted on 200 HCWs. Nasal swabs were collected during February through April 2015, and cultured on blood and mannitol salt agar. The isolates were identified as S. aureus based on morphology, coagulase test, DNase test and mannitol salt agar fermentation. Disk diffusion antibiotic susceptibility tests were performed according to the guidelines of the Clinical and Laboratory Standards Institute. MRSA were confirmed by detection of the mecA gene by PCR. Out of the 200 healthcare workers, 62 (31%) carried S. aureus, of which 51 (82.3%) were MRSA. Therefore, 25.5% of all HCWs were identified as MRSA carriers. MRSA carriage rate was highest among nurses (30.4%) whereas the carriage rate among doctors was (16%). The majority of MRSA carriers were workers of internal medicine department and surgical wards (41.3 and 35% respectively). Out of the 51 MRSA isolates identified by oxacillin disc resistance, 40 were confirmed by PCR targeting the mecA gene. Penicillin showed the highest rate of resistance among MRSA and MSSA isolates (100%). The high rate of nasal MRSA carriage among healthcare workers found in this study is alarming and highlights the need for adjusted infection control measures to prevent MRSA transmission from HCWs to the vulnerable patient.Reference: El Aila NA, et al. Nasal carriage of methicillin resistant Staphylococcus aureus among healthcare workers at Al Shifa hospital in Gaza Strip. BMC Infectious Diseases. 2017;17:28
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