不同病区金黄色葡萄球菌的耐药性及mecA基因携带差异研究  

Resistance of Staphylococcus aureus isolated from different wards and analysis on the difference in mecA gene carrying

作　　者：贾方增 郑小涛 陈统献 吴先华 

机构地区：[1]台州市第二人民医院检验科,浙江台州317200 [2]浙江省仙居县人民医院检验科,浙江仙居县317300 [3]台州市第二人民医院精神科,浙江台州317200 [4]衢州市柯城区人民医院检验科,浙江衢州324000

出　　处：《中华医院感染学杂志》2014年第7期1567-1569,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅医药卫生研究基金项目(2013KYA222)

摘　　要：目的分析医院不同病区分离的金黄色葡萄球菌耐药性及mecA基因携带差异,为金黄色葡萄球菌感染的预防控制及治疗提供依据。方法来自医院2008年6月-2012年5月350例患者送检的各种标本分离出的金黄色葡萄球菌,其中251例为医院获得性感染,99例为社区获得性感染;采用Microscan Walkaway-96SI全自动细菌鉴定及药敏分析仪对不同病区送检的标本进行鉴定及药敏分析,对分离的金黄色葡萄球菌进行药敏分析,采用PCR检测mecA基因,比较不同病区分离菌株的耐药性差异及mecA基因携带差异。结果共分离金黄色葡萄球菌354株,其中ICU检出率最高,占31.92%,其次为神经内科和普外科,检出95株和64株,分别占26.83%、18.08%,急诊科分离到52株;ICU和神经内科分离的金黄色葡萄球菌耐药率显著高于其他病区,急诊科分离株耐药率最低,均未发现利奈唑胺和万古霉素耐药菌株;对mecA基因检测发现阳性率高达57.63%,不同病区检出率有所不同,ICU和神经内科检出率最高,分别占36.76%和30.88%,急诊科检出最低,占11.77%。结论金黄色葡萄球菌是医院最常见的革兰阳性球菌之一,ICU和神经内科菌株耐药率最高,其携带的mecA基因也最高,而急诊科mecA基因检出最低。OBJECTIVE To investigate the resistant characteristics and mecA carrying of Staphylococcus aureus isolated from different wards ,to direct the doctor to reasonably use the antibacterial agents .METHODS From Jun 2008 to May 2012 ,Staphylococcus aureus was isolated and identified routinely by Microscan Walkaway-96SI from different wards .And the resistance was analyzed by the software .The mecA gene was detected by PCR .And the difference in resistance and mecA gene carrying between different wards was compared .RESULTS A total of 354 strains of Staphylococcus aureus were isolated in our hospital .ICU ward was the most important department from which 113 strains were isolated ,accounting for 31 .92% ,followed by the departments of neurology and general surgery ,in which 95 and 64 strains were detected ,accounting for 26 .83% and 18 .08 % .The emergency depart-ment found 52 strains .Analysis of the susceptibility results showed the isolates from ICU ward and neurology department were significantly higher than other wards .While the emergency department isolates were the lowest . However ,linezolidor vancomycin-resistant strains were not found .For detecting the mecA gene ,the positive rate was 57 .63% ,but different detection rates varied departments .The detection rate of ICU ward and the neurology ward was the highest （36 .76% and 30 .88% ） ,while the detection rate of emergency department was the lowest , only 11 .77% .CONCLUSION Staphylococcus aureus was the most commonly seen gram-positive coccus .The isolation and resistant rate of the isolates from the important departments was more serious .ICU and neurology departments found the highest resistance of Staphylococcus aureus and the highest detection rate of mecA .However ,the detection rate of mecA was the lowest in the emergency department .

关 键 词：金黄色葡萄球菌 耐药 MECA基因 重症监护病房 

分 类 号：R378.1[医药卫生—病原生物学]