3月19日，國(guó)際著名雜志PNAS在線刊登了國(guó)外研究人員的最新研究成果“Patient sharing and population genetic structure of methicillin-resistant Staphylococcus aureus,，”,，文章中，研究者表示醫(yī)院之間病人的共享與MRSA的傳播及其病菌基因相似性有關(guān),。
這項(xiàng)研究中,，醫(yī)院之間共享的病人的數(shù)量越多,，他們身上的MRSA細(xì)菌毒株的基因相似性就越大。由于僅僅幾個(gè)耐甲氧西林金黃色葡萄球菌（MRSA）的克隆被認(rèn)為是造成大多數(shù)致命的醫(yī)院獲得性感染病例的原因,，制止一所醫(yī)院內(nèi)的疾病傳播的措施可能會(huì)影響到這種病原體在另一所醫(yī)院的流行率,。Marc Lipsitch及其同事使用一種基因分型方法來(lái)確定從加州Orange縣的30所醫(yī)院分離出來(lái)的耐甲氧西林金黃色葡萄球菌（MRSA）的基因相關(guān)性是否因?yàn)橐环N很常見的做法而發(fā)生變化。這種做法就是在醫(yī)院之間共享病人,。
研究者發(fā)現(xiàn),，無(wú)論這些醫(yī)院之間的距離如何，那些共享更多病人的醫(yī)院有在基因上更相似的耐甲氧西林金黃色葡萄球菌（MRSA）菌株,。這些細(xì)菌的菌株在治療成年病人的醫(yī)院之間的相似性大于治療成年和兒科病人的醫(yī)院之間的相似性,，這帶來(lái)了一種可能性，即考慮到在美國(guó)成人和兒童醫(yī)院通常是分離的,，在醫(yī)院之間共享病人可能對(duì)耐甲氧西林金黃色葡萄球菌（MRSA）在社區(qū)的傳播負(fù)有責(zé)任。這組作者說(shuō),，對(duì)共享大量病人的醫(yī)院群體進(jìn)行干預(yù)可能有助于更好地阻止耐甲氧西林金黃色葡萄球菌（MRSA）的傳播,。（生物谷Bioon.com）
doi:10.1073/pnas.1113578109
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PMID:
Patient sharing and population genetic structure of methicillin-resistant Staphylococcus aureus
Weixiong Kea, Susan S. Huangb, Lyndsey O. Hudsonc, Kristen R. Elkinsb, Christopher C. Nguyenb, Brian G. Sprattc, Courtney R. Murphyb, Taliser R. Averyd, and Marc Lipsitcha,e,1
Rates of hospital-acquired infections, specifically methicillin-resistant Staphylococcus aureus (MRSA), are increasingly being used as indicators for quality of hospital hygiene. There has been much effort on understanding the transmission process at the hospital level; however, interhospital population-based transmission remains poorly defined. We evaluated whether the proportion of shared patients between hospitals was correlated with genetic similarity of MRSA strains from those hospitals. Using data collected from 30 of 32 hospitals in Orange County, California, multivariate linear regression showed that for each twofold increase in the proportion of patients shared between 2 hospitals, there was a 7.7% reduction in genetic heterogeneity between the hospitals’ MRSA populations (permutation P value = 0.0356). Pairs of hospitals that both served adults had more similar MRSA populations than pairs including a pediatric hospital. These findings suggest that concerted efforts among hospitals that share large numbers of patients may be synergistic to prevent MRSA transmission.
