Intestinal carriage of methicillin resistant Staphylococcus aureus and extended -spectrum β-Lactamase-producing Enterobacte-riacae in hospitalized and nonhospitalized patients and their clinical implications

摘要

Objective:To determine the clinical implication of and intestinal carriage with methicillin resistant Staphylo-coccus aureus (MRSA)and extended spectrum β-lactamase (ESBL)-producing Enterobacteriacae.Methods:A total of 180 stool specimens were screened for MRSA and ESBL-producing enterobacteria .Identification of ESBL-producing Enterobacteriacae was done by MicroScan Walk Away 96 system (Dade Behring Inc.,West Sacramento,CA 95691,USA )and confirmation by double-disc synergy test.MRSA was identified by disc diffusion using 30 μg cefoxitin disc and the MicroScan.Results:The rate of fecal MRSA carriage was 7.8%(14 /180),35.7% (5 /14)were recovered from surgical wards.Three patients (21.4%)had MRSA recov-ered from other body sites,and 2 (14.2%)had in addition ESBL -producing Escherichia coli (E.coli)and Klebsiella pneumoniae (K.pneumoniae)respectively.Four (28.5%)patients with MRSA fecal carriage died. MRSA fecal carriage was recovered from both inpatients and outpatients.Four (2.2%)cases carried ESBL-producing Enterobacteriacae in feces .Three (75%)were from intensive care unit (ICU).One patient had both ESBL-producing E.coli and K.pneumoniae from stool as well as E.coli from tracheal aspirate .Two ICU patients with fecal ESBL died.Conclusion:Fecal screening for MRSA and ESBL of all patients at high risk admitted to different hospital wards and ICUs and implementing infection control measures were recommended.