Носительство метициллин-резистентного золотистого стафилококка в носовой полости в больницах третьего уровня: доказательства внутрибольничной передачи инфекции в Нигерии

Носительство метициллин-резистентного золотистого стафилококка (MRSA) в носовой полости является значительным источником инфекции и передачи инфекции в больничных условиях. Эффективный инфекционный контроль и рациональное использование антибиотиков затруднены в странах с низким и средним уровнем дохода из-за отсутствия данных местного мониторинга. В этом исследовании изучались распространенность, характер антимикробной резистентности и генетические детерминанты MRSA у пациентов и медицинских работников в 2 больницах третьего уровня в Нигерии. Всего было собрано 1309 образцов мазков из носовой полости у стационарных пациентов, медицинских работников и амбулаторных пациентов из 2 разных больниц третьего уровня. Золотистый стафилококк был идентифицирован и выделен с использованием стандартных биохимических методов. MRSA были фенотипически обнаружены с использованием хромагара Brilliance MRSA и цефокситина, после чего проводилось тестирование на чувствительность к антимикробным препаратам по стандартному методу дисковой диффузии Кирби – Бауэра. Для скрининга генов mecA и pvl в 10 случайно выбранных образцах MRSA использовались ПЦР-специфические праймеры. Из 1309 собранных образцов из носовой полости было выделено 575 штаммов S. aureus, что составляет 43,9%, из которых 96 (17%) были MRSA, 81 – от стационарных/амбулаторных пациентов и 15 – от медицинских работников. Наибольшее количество MRSA было обнаружено у стационарных пациентов и врачей – 73/81 и 8/15 соответственно. Все изоляты MRSA, устойчивые к цефокситину, также оказались устойчивыми к тетрациклину, амоксициллину и амоксициллину-клавулановой кислоте. Гены mecA и pvl были обнаружены в 5 изолятах. Однако ген pvl был обнаружен в 1 изоляте без соответствующего обнаружения гена mecA. Высокая частота носительства MRSA среди пациентов и медицинского персонала подчеркивает потенциал внутрибольничной передачи инфекции и необходимость усиления инфекционного контроля и рационального использования антибиотиков в нигерийских больницах третьего уровня.

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