内科病区金黄色葡萄球菌耐药性及分子流行特征分析

发布时间：2018-11-11 19:35

【摘要】：目的了解医院内科病区金黄色葡萄球菌临床分离株的分子特征及其对临床常用抗菌药物的耐药情况,为防控金黄色葡萄球菌感染及临床治疗提供依据。方法收集2011年6月-2016年3月期间乌鲁木齐地区一所三甲医院内科病区临床分离的202株金黄色葡萄球菌,应用PCR方法鉴定耐甲氧西林金黄色葡萄球菌(MRSA)和甲氧西林敏感金黄色葡萄球菌(MSSA),应用多位点序列分型(MLST),spa分型,SCCmec分型等方法进行分析,检测pvl毒力基因的携带率,采用VITEK-2Compact全自动微生物分析仪完成药敏试验。结果 202株金黄色葡萄球菌中78株为MRSA,124株为MSSA;78株MRSA分为5种ST型和9种spa型,优势流行克隆为CC5-ST239-MRSA-III-t030占71%;124株MSSA分为20种ST型,36种spa型,优势流行克隆为CC22-ST22-MSSA-t309;CC5-ST239-MRSA-III克隆是造成心脑血管病及呼吸道疾病患者感染的主要克隆;CC22-ST22-MSSA-t309则是引起肿瘤及肾脏病患者感染的主要克隆,而ST121-MSSA克隆主要在糖尿病患者中检出。MRSA菌株的pvl毒力基因检出率为14.1%,MSSA为41.9%;药敏结果显示主要流行克隆ST239-MRSA-III-t030具有两种主要耐药谱,MSSA中CC7克隆群为多药耐药菌株。结论医院内科病区流行的MRSA以ST239-MRSA-III-t030为主,MSSA以ST22-MSSA-t309为主,引起不同疾病感染的主要克隆存在差异,发现多药耐药及高毒力MSSA菌株。
[Abstract]:Objective to investigate the molecular characteristics of clinical isolates of Staphylococcus aureus and their resistance to common antimicrobial agents in hospital, and to provide evidence for the prevention and control of Staphylococcus aureus infection and its clinical treatment. Methods from June 2011 to March 2016, 202 strains of Staphylococcus aureus (Staphylococcus aureus) were collected from a medical ward of a third Class A Hospital in Urumqi. Methicillin resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA),) were identified by PCR and analyzed by multilocus sequence typing (MLST), spa) and SCCmec typing. To detect the carrying rate of pvl virulence gene, VITEK-2Compact automatic microbiological analyzer was used to complete the drug sensitivity test. Results among the 202 strains of Staphylococcus aureus, 78 strains were MRSA,124, MSSA;78 strain, MRSA was divided into 5 ST types and 9 spa types, and the dominant clone was CC5-ST239-MRSA-III-t030, which accounted for 71%. 124 strains of MSSA were divided into 20 ST types and 36 spa types. The dominant clone was CC22-ST22-MSSA-t309;CC5-ST239-MRSA-III clone, which was the main clone of patients with cardio-cerebrovascular diseases and respiratory diseases. CC22-ST22-MSSA-t309 was the main clone that caused infection in patients with tumor and kidney disease, while ST121-MSSA clone was mainly detected in diabetic patients. The detection rate of pvl virulence gene of MRSA strain was 14.1% and 41.9% respectively. The results of drug sensitivity showed that the main popular clone ST239-MRSA-III-t030 had two main drug resistance profiles, and the CC7 clone group in MSSA was multidrug resistant strain. Conclusion ST239-MRSA-III-t030 and ST22-MSSA-t309 are the main MRSA and ST22-MSSA-t309 among the prevalent MRSA strains in the hospital. There are differences in the major clones that cause different disease infection. The multidrug resistance and high virulence MSSA strains were found.
【作者单位】：中国人民解放军新疆军区总医院检验科;新疆生产建设兵团疾病预防控制中心;
【基金】：国家自然科学基金资助项目(81401703)
【分类号】：R446.5

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