美国2002-2006年万古霉素耐药的金黄色葡萄球菌统计

David

Clinical Infectious Diseases 2008;46:668–674

MAJOR ARTICLE
Vancomycin-Resistant Staphylococcus aureus in the United States, 2002–2006
美国2002-2006年万古霉素耐药的金黄色葡萄球菌统计
Dawn M. Sievert,1,2
James T. Rudrik,1
Jean B. Patel,2
L. Clifford McDonald,2
Melinda J. Wilkins,1 and
Jeffrey C. Hageman2

1Michigan Department of Community Health, Lansing; and 2Centers for Disease Control and Prevention, Atlanta, Georgia

Background.  This report compares the clinical characteristics, epidemiologic investigations, infection-control evaluations, and microbiologic findings of all 7 of the cases of vancomycin-resistant Staphylococcus aureus (VRSA) infection in the United States during the period 2002–2006.

Methods.  Epidemiologic, clinical, and infection-control information was collected. VRSA isolates underwent confirmatory identification, antimicrobial susceptibility testing, pulsed-field gel electrophoresis, and typing of the resistance genes. To assess VRSA transmission, case patients and their contacts were screened for VRSA carriage.

Results.  Seven cases were identified from 2002 through 2006; 5 were reported from Michigan, 1 was reported from Pennsylvania, and 1 was reported from New York. All VRSA isolates were vanA positive and had a median vancomycin minimum inhibitory concentration of 512 μg/mL. All case patients had a history of prior methicillin-resistant S. aureus and enterococcal infection or colonization; all had several underlying conditions, including chronic skin ulcers; and most had received vancomycin therapy prior to their VRSA infection. Person-to-person transmission of VRSA was not identified beyond any of the case patients. Infection-control precautions were evaluated and were consistent with established guidelines.

Conclusions.  Seven patients with vanA-positive VRSA have been identified in the United States. Prompt detection by microbiology laboratories and adherence to recommended infection control measures for multidrug-resistant organisms appear to have prevented transmission to other patients.

[ 本帖最后由 David 于 2008-4-30 10:45 编辑 ]

星火

国从2002到2006年监测到7例VRSA,耐万古霉素的金葡菌已经存在了?

楚楚

1992年美国首次发现了可对万古霉素产生耐药性的MRSA。

harmoni

景
本文旨在对2002年-2006年期间在美国发现的所有7个耐万古霉素金黄色葡萄球菌感染案例的临床特征、流行病学调查、感控评估和微生物学进行对比分析。
方法
收集流行病学、临床和感控信息。了解VRSA的分离、细菌敏感试验、脉冲场凝胶电泳和耐药基因分型，对VRSA传播途径和病例间的联系进行评估，以此作为筛查VRSA携带者的依据。
结果
确定在2002-2006年间有7例被发现，其中5例报道自密歇根州，1例报道自宾夕法尼亚州，1例报道自纽约州。所有分离的VRSA均呈vanA（耐药基因）阳性，且万古霉素的最小抑菌浓度为512μg/mL。所有病例均有耐甲氧西林葡萄球菌和肠球菌的感染和携带史，且都存在多种基础疾病，包括慢性皮肤溃疡。他们中的多数人在VRSA感染前接受过万古霉素治疗。从这些病人中还未确定存在人与人之间的VRSA传播。所有的感染预防、评价措施都严格地依照已制定的指南执行。
结论
所有分离自美国的7例VRSA均呈vanA阳性。提高微生物实验室的分离能力和采取推荐的多重耐药菌感染控制措施都有可能防止传染其他患者。
（译得不好，敬请指正。）