老年患者耐甲氧西林金黄色葡萄球菌流行病学及多位点序列分型研究

发布时间：2018-04-30 01:12

  本文选题：耐甲氧西林金黄色葡萄球菌 + 流行病学　； 参考：《中华医院感染学杂志》2017年23期

【摘要】：目的研究老年患者耐甲氧西林金黄色葡萄球菌(MRSA)的流行病学及多位点序列分型。方法随机选取医院检验科2016年5月-2017年5月间收集老年患者临床样本分离MRSA菌株30株,分别进行药敏鉴定试验,建立多位点序列分型(MLST)方法并检测染色体7个管家基因,测序结果与MLST数据库网站已有序列比对,进行聚类分析,统计克隆系及ST菌株亲缘关系发育树,并分析MLST耐药性影响因素。结果 MRSA菌株分2大集群A和B,A群由USA100和USA800型组成,B群由USA300和USA700型菌株组成;所有分离菌株均为耐苯唑西林、阿莫西林/克拉维酸菌株;10株耐药菌对万古霉素的最低抑菌浓度(MIC)1μg/mL;Logistic回归分析结果显示,PVL阳性与万古霉素MIC增加存在显著相关性(P0.05)。结论本研究数据表明老年患者MRSA分离株均为耐苯唑西林、阿莫西林/克拉维酸菌,针对老年患者临床用药时,需考虑相关影响因素进行防控。
[Abstract]:Objective to study the epidemiology and multi-locus sequence typing of MRSAs resistant to methicillin-resistant Staphylococcus aureus in elderly patients. Methods from May 2016 to May 2017, 30 strains of MRSA strains were randomly selected from clinical samples of elderly patients in our hospital. The drug sensitivity test was carried out, and the multilocus sequence typing method was established and 7 housekeeping genes were detected. Sequencing results were compared with MLST database site, cluster analysis was carried out, clone lines and ST-strain phylogenetic tree were analyzed, and the influencing factors of MLST resistance were analyzed. Results MRSA strains were divided into two groups: group A and B were composed of USA100 and USA800, group B was composed of USA300 and USA700, and all isolates were oxacillin resistant. The minimum inhibitory concentration of amoxicillin / clavulanic acid resistant strains to vancomycin was 1 渭 g / mL logistic regression analysis showed that there was a significant correlation between the positive concentration of amoxicillin / clavulanic acid and the increase of vancomycin MIC. Conclusion the data of this study indicate that the isolates of MRSA in elderly patients are oxacillin resistant, amoxicillin / clavulanic acid bacteria, and the related factors should be considered to prevent and control the clinical use of Amoxicillin / clavulanic acid in elderly patients.
【作者单位】： 齐齐哈尔医学院附属第二医院检验科;
【基金】：黑龙江省教育厅基金资助项目(12531807)
【分类号】：R446.5;R515
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本文编号：1822396