ABSTRACT

Objective: This study assessed the prevalence of MRSA, ESBL and VRE in students from four dental schools in Europe.

Methods: The hand, tongue and nostrils of the students who treated patients (study group) and who did not treat patients (control group) were sampled. After incubation in TSB and subculturing in the presence of 4 µg/ml oxacillin, positive cultures were identified for Staphylococcus aureus by Mannitol salt agar and agglutination tests. The presence of MRSA was confirmed by specific PCR on the species and on the SSCmec genes. ESBL and VRE were isolated using specific CHROMagar and confirmed using antibiotic sensitivity tests.

Results: Of the 879 students who participated in this study (454 students which treated patients, 425 controls) a total of 50 students (5.7%) tested positive for a multi-drug resistant bacterium (MDRB); 13 (1.5%) students tested positive for MRSA, 26 (3.0%) for ESBL and 12 (1.4%) for VRE. No statistically significant differences were found between the students who treated patients compared to the control group for any of the MDRB and study centres, excluding MRSA carriage in the Italian student population. The use of antibiotics the year before sampling, was positively associated with the presence of an MDRB (OR 2.0; 95% Confidence Interval 1.10–3.68; p = 0.02).

Conclusion: The risk for MDRB carriage and sequential transmission of MDRB for dental health care students and their patients were acceptably low.

摘要

目的：本研究评估了来自欧洲四所牙科学校的学生中 MRSA、ESBL 和 VRE 的患病率。

方法：对治疗患者（研究组）和未治疗患者（对照组）的学生的手、舌和鼻孔进行采样。在 TSB 中孵育并在 4 µg/ml 苯唑西林存在下进行继代培养后，通过甘露醇盐琼脂和凝集试验确定了金黄色葡萄球菌的阳性培养物。通过对物种和SSCmec基因的特异性 PCR 证实了 MRSA 的存在。ESBL 和 VRE 使用特定的 CHROMagar 进行分离，并使用抗生素敏感性测试进行确认。

结果：在参与本研究的 879 名学生（454 名治疗患者，425 名对照组）中，共有 50 名学生（5.7%）的多重耐药菌（MDRB）检测呈阳性；13 名 (1.5%) 学生的 MRSA 检测呈阳性，26 名 (3.0%) 的 ESBL 和 12 名 (1.4%) 的 VRE 检测呈阳性。与任何 MDRB 和研究中心的对照组相比，治疗患者的学生之间没有发现统计学上的显着差异，不包括意大利学生群体中的 MRSA 携带。采样前一年使用抗生素与 MDRB 的存在呈正相关（OR 2.0；95% 置信区间 1.10–3.68；p = 0.02）。

结论: 牙科保健学生及其患者携带 MDRB 和顺序传播 MDRB 的风险低，可以接受。