| Summary: | 碩士 === 國立陽明大學 === 公共衛生研究所 === 100 === Staphylococcus aureus is a major cause of serious infections in both hospitals and the community and the increasing rates of methicillin- resistant Staphylococcus aureus（MRSA）infection is now a health problem worldwide. The prevalence of MRSA from medical centers in Taiwan was reported to account for 60%-80% of all S. aureus isolates. Studies have shown that through surveillance of nasal MRSA colonization, and implementation of the contact isolation measures can reduce nosocomial infection and colonization rates. However, recolonization by different strains is possible after initial eradication. This study investigate the molecular epidemiology of MRSA strains from a surveillance in a medical center, and analyze whether the colonization strains may change.
In our 182 cases, a total of 185 strains were collected. The imported rate and acquired rate were 20.3% and 22.1%, respectively. 20.8-27.3% of the cases showed strains changed, 13-15% of cases displayed conlonization disappeared, and 2-3% of cases revealed recolonization. The most important nasal strains is identified ST239/ SCCmec III or IIIA (54.3%), followed by ST5/ SCCmec II or III (25.7%), and ST59/ SCCmec III or IV(14.3%), and other types. Risk factors of MRSA colonization are significantly associated with pressure sore and history of previous MRSA infection within one year. The case number of environmental isolates is insufficient to analyze whether it is related with the patient colonization.
Without intervention, the patient's nasal colonization strains may change. Whether interventional measures can change the patient status of the colonization, or colonization increases the occurrence of nosocomial infection, requires further research.
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