3月19日，国际著名杂志PNAS在线刊登了国外研究人员的最新研究成果“Patient sharing and population genetic structure of methicillin-resistant Staphylococcus aureus，”，文章中，研究者表示医院之间病人的共享与MRSA的传播及其病菌基因相似性有关。
这项研究中，医院之间共享的病人的数量越多，他们身上的MRSA细菌毒株的基因相似性就越大。由于仅仅几个耐甲氧西林金黄色葡萄球菌（MRSA）的克隆被认为是造成大多数致命的医院获得性感染病例的原因，制止一所医院内的疾病传播的措施可能会影响到这种病原体在另一所医院的流行率。Marc Lipsitch及其同事使用一种基因分型方法来确定从加州Orange县的30所医院分离出来的耐甲氧西林金黄色葡萄球菌（MRSA）的基因相关性是否因为一种很常见的做法而发生变化。这种做法就是在医院之间共享病人。
研究者发现，无论这些医院之间的距离如何，那些共享更多病人的医院有在基因上更相似的耐甲氧西林金黄色葡萄球菌（MRSA）菌株。这些细菌的菌株在治疗成年病人的医院之间的相似性大于治疗成年和儿科病人的医院之间的相似性，这带来了一种可能性，即考虑到在美国成人和儿童医院通常是分离的，在医院之间共享病人可能对耐甲氧西林金黄色葡萄球菌（MRSA）在社区的传播负有责任。这组作者说，对共享大量病人的医院群体进行干预可能有助于更好地阻止耐甲氧西林金黄色葡萄球菌（MRSA）的传播。（生物谷Bioon.com）
doi:10.1073/pnas.1113578109
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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.
