アメリカインディアンの田舎のコミュニティで,コミュニティで得られたメチチリン耐性黄色のスタフィロコクスが発見されました
A V Groom1, D H Wolsey, T S Naimi
1Indian Health Service National Epidemiology Program, 5300 Homestead Rd NE, Albuquerque, NM 87110, USA.
JAMA
|September 18, 2001
まとめ
コミュニティで得られたメチチリン耐性黄金球菌 (MRSA) 感染症が農村部で発生し,メチチリン感受性黄金球菌 (MSSA) を代替する可能性がある. この研究は,田舎のアメリカインディアンコミュニティにおけるコミュニティMRSAの発生とリスク要因を記録しています.
科学分野:
- 感染症 感染症は感染症です.
- エピデミオロジー エピデミオロジー
- 微生物学 微生物学とは
背景:
- メチシリン耐性黄色のスタフィロコーカス (MRSA) は,歴史的に医療環境と関連付けられてきました.
- 健康な子供の最近の重度のMRSA感染は,コミュニティでの獲得が増加していることを示唆しています.
- この研究では,MRSAを農村地域の環境で調査しています.
研究 の 目的:
- コミュニティで得られたMRSA感染の発生率を記録する.
- コミュニティで得られたMRSAの危険因子をメチチリン感受性S aureus (MSSA) と比較する.
- MRSA菌株の遺伝的関連性を分析する.
主な方法:
- 医療記録のレビューを利用した遡及的なコホート研究.
- 中西部の田舎のインディアンコミュニティのインディアン保健サービス施設で行われた研究.
- 分析には,MRSA分類,危険因子比較,および株型決定のためのパルスフィールドゲル電泳 (PFGE) が含まれていました.
主要な成果:
- スタフィロコッカス・オーレウス単離体112種のうち,MRSAは62%でMSSAは45%でした.
- MRSA感染の有意な割合 (74%) はコミュニティで感染した.
- コミュニティで感染したMRSAとMSSAのリスク因子の有意な違いは見つかりませんでした.
- PFGEは,コミュニティで獲得されたほとんどのMRSA菌株は,クローン関連であり,入院菌株とは異なることを明らかにしました.
結論:
- コミュニティで感染したMRSAは,この農村地域における支配的な菌株であり,MSSAを潜在的に置き換える可能性があるようです.
- 研究結果は,MRSAが米国の田舎地域社会で広く拡散しており,病院を超えて広がっていることを示唆しています.
- 抗菌剤の感受性と菌株のタイプ化は,非ノソコミアル環境におけるMRSAの広範な存在を支持しています.
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