ICU患者分离金黄色葡萄球菌的耐药性及分子流行病学特征

发布时间：2018-04-14 09:22

本文选题：重症监护病房 + 金黄色葡萄球菌　；参考：《中国感染控制杂志》2016年05期

【摘要】：目的了解某院重症监护病房(ICU)金黄色葡萄球菌的耐药特点及分子流行病学特征。方法收集2014年1—12月该院ICU分离的金黄色葡萄球菌,进行细菌鉴定及药物敏感性试验,采用金黄色葡萄球菌A蛋白(spa)分型及多位点序列分型(MLST)方法进行分型。结果 160株金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌(MRSA)120株(占75.00%)。MRSA对红霉素、克林霉素、左氧氟沙星的耐药率均80%;MSSA对头孢唑林敏感,对红霉素、克林霉素、左氧氟沙星的耐药率分别为62.50%、35.00%、10.00%。spa分型和MLST结果显示,120株MRSA主要为ST239-t030、ST239-t037、ST5-t2460 3种型别,其中ST239-t030(105株,87.50%)为主要流行菌株,8个ICU均有检出;MSSA存在较多型别,ST59-t437仅在神经内科(8株)和消化科(2株)检出,ST6-t701、ST398-t3625、ST398-t1793和ST121-t2092分别仅在神经内科(7株)、麻醉科(5株)、神经外科(4株)和心外科(4株)检出。结论该院ICU MRSA分离率较高,以ST239-t030克隆株为主,存在医院内流行;不同型别MSSA在各科室内存在流行趋势。
[Abstract]:Objective to investigate the characteristics of drug resistance and molecular epidemiology of staphylococcus aureus in intensive care unit (ICU).Methods Staphylococcus aureus isolated from January to December 2014 in our hospital was collected for bacterial identification and drug sensitivity test. Staphylococcus aureus A protein spares typing and multiple locus sequence typing were used to type Staphylococcus aureus.Results among the 160 strains of Staphylococcus aureus, 120 strains of methicillin-resistant Staphylococcus aureus (75.00%).MRSA) were resistant to erythromycin, clindamycin, levofloxacin, and were sensitive to cefazolin, erythromycin and clindamycin.The drug resistance rates of levofloxacin were 62.50 and 35.00, respectively. The results of SPA typing and MLST analysis showed that there were three types of ST239-t037ST5-t2460 in MRSA, which were divided into two groups: ST239-t030, ST239-t037ST5-t2460, ST239-t037ST5-t2460, ST239-t037ST5-t2460.Among them, ST239-t030(105 strain (87.50) was the main prevalent strain. There were 8 strains of ST59-t437 in neurology and 2 strains in digestive department.) ST6-t701, ST398-t3625 ST398-t1793 and ST121-t2092 were detected only in 7 strains of neurology, 5 strains of anesthesiology and 4 strains of neurosurgery, respectively.Strain) and cardiac surgery (4 strains) were detected.Conclusion the isolation rate of ICU MRSA in our hospital is high, the clone of ST239-t030 is the main one, and the different types of MSSA are prevalent in different departments.
【作者单位】：第四军医大学西京医院全军临床检验医学研究所;
【基金】：陕西省自然科学基金资助项目(2014JM4188)
【分类号】：R446.5

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