アブストラクト（38巻2/3号：神奈川歯学）

神奈川歯学

Japanese

Title　： 神奈川歯科大学学生からのMRSAの検出‐MSO寒天培地上に発育した細菌の性状検査について‐
Subtitle　：
Authors　： 平嶺浩子, 岩宮万里子*, 梅本俊夫, 新藤潤一**
Authors（kana）　：
Organization　： 神奈川歯科大学口腔細菌学教室, *神奈川歯科大学臨床検査科, **神奈川歯科大学口腔外科学第1講座
Journal　： 神奈川歯学
Volume　： 38
Number　： 2/3
Page　： 92-99
Year/Month　： 2003 / 9
Article　： 原著
Publisher　： 神奈川歯科大学学会
Abstract　： 院内感染の原因菌として注目されているMRSA(methicillin-resistant Staphylococcus aureus)は, 1961年にその存在を英国で報告されて以来, 免疫力が低下している入院患者や老人などの易感染者に対し接触感染や飛沫感染により感染し, 肺炎や敗血症などの重篤な感染症を引き起こすことから, 臨床上重要な細菌となっている. そもそもStaphylococcus aureusは, 健常人から16%程度の割合で分離される細菌であり, 歯科領域に関係の深い鼻腔および咽頭粘膜に常在菌として存在している. メチシリンに耐性であるMRSAは, ほとんどのβ-lactam剤に耐性を示し, バンコマイシンなどの限られた化学療法剤だけが有効であるため, 感染患者の治療が非常に困難である. またMRSAが口腔外科手術後の創傷感染の起炎菌となり, 慢性骨髄炎へ移行し対処に苦慮したという報告や, 最近ではバンコマイシン耐性を示すvancomycin-resistant MRSAも出現したという報告もある.
Practice　： 歯科学
Keywords　： MRSA, Nosocomial infection, S. aureus, mecA

English

Title　： Detection of MRSA in Students of Kanagawa Dental College ―Biological Properties and Identification of Bacteria Grown on MSO Agar Plates―
Subtitle　：
Authors　： Hiroko HIRAMINE, Mariko IWAMIYA*, Toshio UMEMOTO, Junichi SHINDO**
Authors（kana）　：
Organization　： Departments of Oral Microbiology, Kanagawa Dental College, *Departments of Clinical Laboratory, Kanagawa Dental College, **1st Departments of Oral and Maxillafacial Surgery, Kanagawa Dental College
Journal　： Kanagawa Shigaku
Volume　： 38
Number　： 2/3
Page　： 92-99
Year/Month　： 2003 / 9
Article　： Original article
Publisher　： Kanagawa Odontological Society
Abstract　： Infection caused by methicillin-resistant Staphylococcus aureus (MRSA) is a growing concern in medical centers, because almost all antibiotics have no effect on it. In our medical center, we have continually surveyed the frequency of our staffs and inpatients as MRSA carriers at the department of oral surgery to prevent expansion of MRSA contagion since 1995. In this study, we performed screening tests to detect MRSA on 349 students from 2000 to 2002. Samples from the nasal cavities and pharynxes were cultured onto mannitol salt oxacillin agar (MSO agar) plates. Then the isolates were examined for biological properties, antibiotic susceptibilities, and polymerase chain reaction (PCR) to identify MRSA. The mecA and nuc genes were used to identify methicillin-resistant bacteria and Staphylococcus aureus, respectively. Bacterial growths on MSO agar plates were observed in 29 of 349 students, and a total of 30 strains were isolated from nasal and pharynx samples. One strain was identified as S. aureus and coagulase-negative Staphylococci (CNS) were detected in 26 out of all the specimens by mannitol degradation, hemolytic activity and coagulase activity. Antibiotic sensitivity testing showed that vancomycin (VCM) had potent activity against all isolates, whereas oxacillin (MPIPC) was not effective on 19 stains of Staphylococci. The identified S. aureus strain, by biological testing, was found to have the nuc gene ; however, the mecA was not amplified by PCR. Amplification of the mecA gene was observed in 19 strains that were not S. aureus. Thus, MRSA was not detected in this study. However methicillin-resistant Staphylococcus epidermidis (MRSE) and methicillin-resistant coagulase-negative Staphylococci (MRCNS) were isolated at a frequency of 5.4%. These results suggest that it is necessary to maintain surveillance and control not only MRSA but also MRCNS infections in medical centers.
Practice　： Dentistry
Keywords　： MRSA, Nosocomial infection, S. aureus, mecA