英国产科医院爆发 PVL 阳性 MRSA 疫情及控制措施

IF 3.9 3区 医学 Q1 INFECTIOUS DISEASES
H. Barnsley , S. McFall , R. White , S. Suleman , B. Pichon , M. Patel
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引用次数: 0

摘要

本文旨在介绍英国一家产科和新生儿医院对经全基因组测序(WGS)证实的 USA300 ST8 潘顿-凡尔登白葡菌素阳性耐甲氧西林金黄色葡萄球菌(PVL-MRSA)疫情的调查和控制情况。通过使用感染控制监控数据库、对保存的 MRSA 分离物进行分型、加强患者筛查和员工筛查,开展了一项回顾性工作,以确定更多病例。此外还进行了环境筛查。疫情爆发期间,从 2021 年 7 月 11 日至 2022 年 12 月 22 日,共发现 18 例病例:10/18 例为感染,8/18 例为定植。一名医护人员(HCW)对同一菌株的定植检测呈阳性,环境拭子检测发现了受污染的医院 IT 设备。通过清除定植的医护人员和采取感染预防与控制(IPC)措施,疫情被终止。自疫情结束后,社区中又出现了具有类似分子特征的 PVL-MRSA 病例。不让他们工作并对他们进行去殖民化是防止病例进一步增加的关键。WGS 在识别和联系病例方面很有价值。鉴定出具有相似分子特征的 PVL-MRSA 社区病例证实了该病菌在医疗机构之外的传播。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Emergence and control of an outbreak of PVL-positive MRSA in a UK-based maternity setting

This paper aims to describe the investigation and control of an outbreak of USA300 ST8 Panton–Valentine leucocidin (PVL)-positive meticillin-resistant Staphylococcus aureus (MRSA), confirmed by whole genome sequencing (WGS), within a maternity and neonatal setting in the UK. The identification of two linked PVL-MRSA cases led to an outbreak investigation. A lookback exercise conducted using the infection control surveillance database, typing of saved MRSA isolates, enhanced patient screening, and staff screening were used to identify further cases. Environmental screening was also performed. Genetic relatedness between isolates was assessed by WGS. During the outbreak, 18 cases were identified between 11th July 2021 and 22nd December 2022: 10 cases were infections and eight cases were colonizations. A healthcare worker (HCW) tested positive for colonization with the same strain, and environmental swabbing identified contaminated information technology equipment in the hospital. The outbreak was brought to an end by exclusion of the colonized HCW from work, and infection prevention and control measures. Since the end of the outbreak, cases of PVL-MRSA with similar molecular profiles have been found in the community. It is likely that the HCW played a role in the transmission of PVL-MRSA. Their exclusion from work and decolonization were key to preventing further cases. WGS was valuable in identifying and linking cases. The identification of community cases of PVL-MRSA with similar molecular profiles confirms transmission of the organism outside of healthcare settings.

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来源期刊
Journal of Hospital Infection
Journal of Hospital Infection 医学-传染病学
CiteScore
12.70
自引率
5.80%
发文量
271
审稿时长
19 days
期刊介绍: The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience. The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that: provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings; provide new insight into cleaning, disinfection and decontamination; provide new insight into the design of healthcare premises; describe novel aspects of outbreaks of infection; throw light on techniques for effective antimicrobial stewardship; describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control; improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change; improve understanding of the use of IT systems in infection surveillance and prevention and control.
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