英国中西部社区获得性MRSA感染的流行病学

David

Journal of Hospital Infection Volume 70, Issue 4, December 2008, Pages 314-320 Epidemiology of community-acquired meticillin-resistant Staphylococcus aureus obtained from the UK West Midlands region 英国中西部社区获得性MRSA感染的流行病学 J. Rollasona,                                 登录/注册后可看大图 ,                                 登录/注册后可看大图 , L. Bastinb, A.C. Hiltona, D.G. Pillayc, T. Worthingtona, C. McKeonc, P. Dec, K. Burrowsc and P.A. Lamberta aSchool of Life and Health Sciences, University of Aston, Birmingham, UK bSchool of Engineering and Applied Science, University of Aston, Birmingham, UK cGood Hope Hospital, Heart of England NHS Foundation Trust, Sutton Coldfield, Birmingham, UK Received 16 May 2008;   accepted 5 August 2008.   Available online 10 October 2008. SummaryBetween January 2005 and December 2005, 199 meticillin-resistant Staphylococcus aureus (MRSA) isolates were obtained from non-hospitalised patients presenting skin and soft tissue infections to local general practitioners. The study area incorporated 57 surgeries from three Primary Care Trusts in the Lichfield, Tamworth, Burntwood, North and East Birmingham regions of Central England, UK. Following antibiotic susceptibility testing, pulsed-field gel electrophoresis, Panton–Valentine leukocidin gene detection and SCCmec element assignment, 95% of the isolates were shown to be related to hospital epidemic strains EMRSA-15 and EMRSA-16. In total 87% of the isolate population harboured SCCmec IV, 9% had SCCmec II and 4% were identified as carrying novel SCCmec IIIa-mecI. When mapped to patient home postcode, a diverse distribution of isolates harbouring SCCmec II and SCCmec IV was observed; however, the majority of isolates harbouring SCCmec IIIa-mecI were from patients residing in the north-west of the study region, highlighting a possible localised clonal group. Transmission of MRSA from the hospital setting into the surrounding community population, as demonstrated by this study, warrants the need for targeted patient screening and decolonisation in both the clinical and community environments. Keywords: Community; EMRSA-15; EMRSA-16; Meticillin-resistant Staphylococcus aureus; Pulsed-field gel electrophoresis; SCCmec