The world is now being faced with the battle for antimicrobial resistant
organisms(ARO), such as MRSA, PRSP, ESBL producing GNR, MDRP and VRSA.
These AROs are causing hospital-acquired infections(HAI) by the way of
person-to -person transmission.
The role of microbiological laboratories in hospitals is quite important
in controlling HAI. Firstly, accurate detection of AROs is essential. They
have to be proficient in both isolation and detection of AROs. Secondly,
they have to return the results rapidly for not only clinicians but infection
control team(ICT) to prevent more spread of HAI if an isolated organism
is ARO. Thirdly, they have to report the statistical data about isolated
organisms for ICT in each hospital.
AROs can be isolated by three major methods, detection of responsible resistant genes or proteins and antimicrobial susceptibility tests. Most laboratories isolate AROs, using one or two of these methods. They should be prepared for and follow the most current criteria of AROs by Japanese original standard, or presented from NCCLS.
Microbiological laboratories should also play a role in both hospital epidemiology
and appropriate antimicrobial use by providing useful information, annual
or periodical reports of antimicrobial susceptibility for isolated organisms
which are relevant in their hospital.
The microbiological laboratory which have good skills in detecting AROs, analyzing epidemiological data and communicating with all hospital workers, is now required from ICT in controlling HAI.
[Rinsho Byori 50 : 860～868, 2002]
*Clinical Laboratory Unit of University Hospital, Kyoto Prefectural University of Medicine, Kyoto 602-8566
【Key Words】antimicrobial resistant organisms : AROs(薬剤耐性菌)，microbiological laboratory(微生物検査室)，hospital acquired infection : HAI(病院感染)，infection control team : ICT(感染対策チーム)
*京都府立医科大学附属病院臨床検査部(〒602-8566 京都市上京区河原町通り広小路上ル梶井町465)
E-mail :tkomori@koto.kpu-m.ac.jp