重庆某医院重症监护室耐甲氧西林金黄色葡萄球菌的分子流行病学  

Tracing the outbreak of methicilin resistant Staphylococcus aureus in intensive care units

作　　者：常李军[1,2] 贾蓓[2] 魏晓宇[2] 黄文祥[2] 刘成伟[2] 

机构地区：[1]运城市中心医院感染科,运城044000 [2]重庆医科大学附属第一医院感染科,重庆市传染病寄生虫病重点实验室,重庆400016

出　　处：《中国抗生素杂志》2012年第8期615-618,共4页Chinese Journal of Antibiotics

基　　金：国家自然科学基金面上项目资助(编号:30973592)

摘　　要：目的了解重庆市某医院重症监护病房耐甲氧西林金黄色葡萄球菌的耐药性及分子流行病学特征。方法收集该院2008年9月至2009年6月神经外科ICU和中心ICU 31株非重复金黄色葡萄球菌,PCR方法检测mecA基因,琼脂稀释法测定其对13种抗菌药物的最低抑菌浓度(MIC),多重PCR方法进行SCCmec分型,脉冲场凝胶电泳技术(PFGE)分析亲缘关系。结果 31株金葡菌中,MRSA占83.9%(26/31),其中25株为SCCmecⅢ型,1株未能分型。26株MRSA对头孢吡肟、头孢唑啉、四环素、红霉素、左氧氟沙星、克林霉素均耐药,对利福平、万古霉素、替考拉宁和利奈唑胺均敏感。PFGE分型26株MRSA有4型(A^D),以A型流行株为主。结论重庆市某医院2008年9月至2009年6月神经外科ICU和中心ICU病房MRSA分离率较高,MRSA菌株为多重耐药菌,未发现VISA或VRSA。SCCmec以III型为主,神经外科ICU病房可能有MRSA的流行,需要采取积极措施阻止其进一步播散流行。Objective To investigate the antibiotic-resistance spectrum and molecular epidemiology profiles of Staphylococcus aureus in Neurosurgery Intensive Care Unit（NICU）and Center Intensive Care Unit（CICU）. Methods A total of 31 Staphylococcus aureus isolates were collected from September 2008 to June 2009 in NICU and CICU. The mecA was detected by PCR; Minimal inhibitory concentrations （MICs） of 13 antimicrobial agents were determined by agar dilution method; SCCmec typing was confirmed by multiplex PCR; The homology among the isolates was analyzed by pulsed-field gel electrophoresis （PFGE）. Results Of 31 clinical isolates, MRSA accounted for 83.9%（26/31）, SCCmec III was identified in 25 MRSA isolates, One MRSA strain was non-typeable. PFGE Analysis identified 4 PFGE patterns from the 26 MRSA strains, most of which were PFGE type A （21 strains）. Conclusions Prevalence of certain types of mecA positive MRSA strains could lead to epidemic outbreak. All MRSA strains were multi-drug resistant. No Vancomycin-resistant strain （VISA or VRSA） was found. SCCmec III is the major SCCmec genotype of MRSA. Efficient infection control measures should be carried out to control MRSA outbreak and spread.

关 键 词：耐甲氧西林金黄色葡萄球菌 SCCmec分型 脉冲场凝胶电泳 

分 类 号：R378.11[医药卫生—病原生物学]