文摘大家译：环境污染与病人胃肠道MRSA和痢疾杆菌的定植

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1: Infect Control Hosp Epidemiol. 2007 Oct;28(10):1142-7. Epub 2007 Aug 3. Links
Widespread Environmental Contamination Associated With Patients With Diarrhea and Methicillin-Resistant Staphylococcus aureus Colonization of the Gastrointestinal Tract.Boyce JM, Havill NL, Otter JA, Adams NM.
Hospital of Saint Raphael, New Haven, CT, 06511, USA. JBoyce@srhs.org.

Objective. Patients colonized with methicillin-resistant Staphylococcus aureus (MRSA) may contaminate their immediate environment with this organism. However, the extent to which gastrointestinal colonization with MRSA affects environmental contamination is not known. We investigated the frequency of environmental contamination in the rooms of patients with diarrheal stools and heavy gastrointestinal colonization with MRSA.Design. Prospective observational study.Setting. A 500-bed teaching hospital.Methods. Stool specimens submitted for Clostridium difficile toxin assays were inoculated onto colistin-naladixic acid agar. MRSA was identified with standard methods. Samples from a standardized list of 10 environmental surfaces were cultured, from the rooms of 8 patients who had diarrhea that yielded heavy growth of MRSA (case patients) and from the rooms of 6 MRSA-positive patients with stool cultures negative for MRSA (control patients). MRSA isolates from 13 patients (8 case patients and 5 control patients) and 64 of the environmental isolates recovered from their rooms were compared by pulsed-field gel electrophoresis (PFGE). One clinical isolate from a control patient was excluded because there was no corresponding environmental MRSA isolate with which to compare it.Results. Overall, MRSA were recovered from 47 (58.8%) of 80 surfaces in the rooms of case patients, compared with 14 (23.3%) of 60 surfaces in the rooms of control patients (58.8% [95% CI, 47.8-68.9] vs 23.3% [95% CI, 14.3-35.5]; P<.0001). The items most commonly contaminated were bedside rails, blood pressure cuffs, television remote controls, and toilet seats. Seventy-eight percent of the environmental isolates in patients' rooms had PFGE types that were indistinguishable or closely related to those recovered from the patients' clinical specimens.Conclusions. Patients who have diarrheal stools and heavy gastrointestinal colonization with MRSA are associated with significantly greater environmental MRSA contamination than patients without MRSA in their stool, and they are likely to be the source of that contamination.
这是一篇发表在感染控制和医院流行病学杂志上的关于医院环境污染与MRSA感染的文章，大家积极参与翻译哦！

[ 本帖最后由 wzcdcyxh 于 2007-9-14 21:00 编辑 ]

David

dssvcxdv Objective. Patients colonized with methicillin-resistant Staphylococcus aureus (MRSA) may contaminate their immediate environment with this organism. （背景：携带有MRSA的病人可能污染他们接触的直接环境。）However, the extent to which gastrointestinal colonization with MRSA affects environmental contamination is not known. （然而，病人的胃肠道定植有MRSA对环境污染的程度目前尚不清楚。）We investigated the frequency of environmental contamination in the rooms of patients with diarrheal stools and heavy gastrointestinal colonization with MRSA.（我们调查了一个病房的环境污染频率，这个病房里的病人会产生腹泻后的粪便并且胃肠道内定植有MRSA）Design. Prospective observational study.Setting. A 500-bed teaching hospital.（课题设计：回顾性观察研究；地点：一家500张床位的教学医院）Methods. Stool specimens submitted for Clostridium difficile toxin assays were inoculated onto colistin-naladixic acid agar. （方法：粪便标本接种于含多粘菌素-萘啶酸的琼脂上作艰难梭菌的毒素测定。）MRSA was identified with standard methods. （用标准方法检测MRSA）Samples from a standardized list of 10 environmental surfaces were cultured, from the rooms of 8 patients who had diarrhea that yielded heavy growth of MRSA (case patients) and from the rooms of 6 MRSA-positive patients with stool cultures negative for MRSA (control patients). （采集10个环境表面的样本作培养，其中分为病例组样本(此病房内有8名腹泻且MRSA重度感染的病人)和对照组样本(此病房内有6名粪便培养MRSA阴性，但实际携带有MRSA的病人)。）MRSA isolates from 13 patients (8 case patients and 5 control patients) and 64 of the environmental isolates recovered from their rooms were compared by pulsed-field gel electrophoresis (PFGE). （13名病人标本(8个病例，5个对照)和64个环境样本中的MRSA菌株用脉冲场凝胶电泳进行基因型比对。）One clinical isolate from a control patient was excluded because there was no corresponding environmental MRSA isolate with which to compare it.（一个分离自对照组的临床标本被排除，原因是没有对应的环境MRSA菌株可以与之比较。）Results.Overall, MRSA were recovered from 47 (58.8%) of 80 surfaces in the rooms of case patients, compared with 14 (23.3%) of 60 surfaces in the rooms of control patients (58.8% [95% CI, 47.8-68.9] vs 23.3% [95% CI, 14.3-35.5]; P<.0001). （结果：总体而言，在病例组，80个环境表面样本中有47个(58.8%)培养出MRSA(95% CI, 47.8-68.9)，相比较，对照组60个环境表面样本有14个(23.3%)MRSA培养阳性(95% CI, 14.3-35.5)，P<.0001）The items most commonly contaminated were bedside rails, blood pressure cuffs, television remote controls, and toilet seats. （最常见被污染的物品为床边围栏、血压计的袖带、电视机的遥控器和厕所的马桶座。）Seventy-eight percent of the environmental isolates in patients' rooms had PFGE types that were indistinguishable or closely related to those recovered from the patients' clinical specimens.（78%的环境样本MRSA与该病房病人的临床标本MRSA，两者的基因型PFGE无法区分，即高度相似。）Conclusions. Patients who have diarrheal stools and heavy gastrointestinal colonization with MRSA are associated with significantly greater environmental MRSA contamination than patients without MRSA in their stool, and they are likely to be the source of that contamination.（结论：那些产生腹泻粪便且胃肠道含有大量MRSA的病人对环境的危害比那些粪便中无MRSA的病人要大得多，这些人很可能就是环境MRSA污染的源头。）:ouuyh :fdafasdf

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