耐甲氧西林金黄色葡萄球菌暴发流行菌株的基因分型研究  

Genotyping of Meticillin-resistant Staphylococcus aureus Outbreak Isolates

作　　者：刘庆中[1] 周铁丽[1] 李超[1] 黄海霞[1] 

机构地区：[1]温州医学院附属第一医院,浙江温州325000

出　　处：《中华医院感染学杂志》2006年第10期1086-1088,共3页Chinese Journal of Nosocomiology

基　　金：浙江省教育厅基金项目资助(20051146);温州医学院科研发展基金项目资助(2003X21)

摘　　要：目的研究急诊重症监护病房(EICU)耐甲氧西林金黄色葡萄球菌(MRSA)暴发流行菌株的分子流行病学特征,以追踪传染源、了解传播途径,确定预防流行的策略。方法采用脉冲场凝胶电泳(PFGE)技术,对我院EICU在2004年12月临床患者感染部位分离的MRSA暴发流行株及暴发期间分离自环境和患者、医务人员携带的MRSA作同源性分析。结果17例患者中有6例感染MRSA,共分离出7株病原菌(其中有两株来自同一患者的不同部位);分别从一患者鼻腔、换药室台面、一护士的手、一病床床栏和病区的空气分离出5株MRSA;12株MRSA的PFGE分型结果显示共有4个型:所有患者感染部位分离的7个菌株和患者鼻腔及护士手上分离的两个菌株都是A型,为暴发菌株;换药室台面、病床床栏和空气中分离的菌株分别为B型、C型和D型。结论基因分型阐明了本次MRSA暴发流行的来源和传播途径,其可能是患者鼻腔携带的MRSA经由医护人员的手在病区中传播。OBJECTIVE To investigate characters of molecular epidemiology of meticillin-resistant Staphylococcus aureus （MRSA） outbreak strains in an emergency intensive care unit （EICU）, to follow-up the possible sources, understand transmission for infection, and determine preventive strategies. METHODS Pulsed-field gel electrophoresis （PFGE） was used to analyze the homology of MRSA strains, isolated from clinical patients＇ infection sites and environment, and carried by patients and healthcare workers in EICU of our hospital in December, 2004. RESULTS Six of 17 patients were infected by MRSA, and 7 strains were isolated （including 2 strains from different sites of the same patient）. Surveillance cultures of ward＇s environments, patients＇ nares and healthcare workers＇ nares and hands were performed in the outbreak period. Five MRSA strains were isolated, including a strain from nares of a patient, a strain from a table-board of a procedure room, a strain from hand of a nurse, a strain from a bed bar, and a strain from ward＇s air. PFGE typing of the 12 MRSA strains showed that all 7 strains isolated from patients＇ infection sites and two strains from nares of a patient and hand of a nurse were of type A. Strains from a procedure room, bed bar and air were of types B, C and D, respectively. CONCLUSIONS MRSA＇s source and its transmission route are elucidated by genotyping. MRSA appears to come from a patient＇s nares and has been transferred in ward by hand of healthcare workers.

关 键 词：耐甲氧西林金黄色葡萄球菌 暴发流行 分子流行病学 脉冲场凝胶电泳 

分 类 号：R378.11[医药卫生—病原生物学]