MRSA在ICU分布情况调查与随机扩增多态性DNA同源性分析  

Investigation of MRSA infection and RAPD homology study in ICU

作　　者：付广林[1] 马筱玲[2] 耿先龙[1] 张义永[2] 高玉录[2] 荚恒敏 

机构地区：[1]蚌埠医学院,安徽省蚌埠市233003 [2]安徽医科大学附属省立医院检验科

出　　处：《中华实用诊断与治疗杂志》2009年第2期147-150,共4页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的:监测ICU医护人员、住院患者,及环境中MRSA的携带及分布情况,以提出针对性预防与控制措施。方法:对本院ICU的20位医护人员、8例住院患者的手、咽和鼻前庭等部位,及ICU环境中的物体表面和空气同时进行采样,采用免疫富集-显色培养基分离MRSA,应用VITEK 32全自动微生物分析仪进行菌种鉴定和药敏试验;对MRSA进行随机引物扩增多态DNA检测并进行同源性分析;比较MRSA的耐药谱分型和随机扩增多态性DNA基因分型之间的差异,判断医护人员、住院患者及环境中分离的MRSA的相关性。结果:共检出31株MRSA,20位医护人员11位检出15株MRSA,8位患者5位检出9株MRSA,分离于同一个体不同部位的重复分离株经随机扩增多态性DNA同源性分析均为同一克隆菌株。52份环境物体表面检出7株MRSA。根据随机扩增多态DNA聚类分析可以将检出的MRSA分为3个类型。结论:医护人员MRSA带菌率较高,部分医务人员、住院患者和环境中分离的MRSA有较高的同源性,ICU存在人与人和人与环境之间的MRSA传播。Objective To investigate the distribution of MRSA isolates among medical workers, inpatients and surroundings in ICU, and make effective countermeasures for prevention and control. Methods The strains of MRSA were isolated from ICU surroundings and the vestibules of noses, hands and pharynxes among health-care workers and inpatients. Immunocapture- CHROMagar MRSA isolation medium was used to confirm MRSA strains. Drug resistance was tested by Vitek-32 automatic microbiology analysis system. A total of 31 isolated strains were typed by randomly amplified polymorphic DNA assay. Results A total of 31 MRSA strains were isolated, among which 15 were isolated from 11 health-care workers, 9 from 5 inpatiens and 7 from 52 surrounding samples. The 31 strains of MRSA could be divided into 3 types according to their RAPD homology. Conclusions The MRSA carriage rate of medical workers is high. The MRSA strains from medical workers, inpatients and surroundings are highly homological, and spread between person and environment in ICU.

关 键 词：MRSA 免疫富集-多重PCR 随机扩增多态性DNA 感染控制 

分 类 号：R515[医药卫生—内科学] R450[医药卫生—临床医学]