临床分离金黄色葡萄球菌的流行病学特征分析  

Analysis of epidemiology characteristics of Staphylococcus aureus isolates from clinical specimens

作　　者：孟祥兆[1] 李桂玲[1] 陈勇 韩黎 多丽波[1] 

机构地区：[1]哈尔滨医科大学附属第二医院检验科,黑龙江哈尔滨150086 [2]解放军疾病预防控制所医院感染监控中心,北京100071

出　　处：《中国卫生检验杂志》2014年第7期1040-1043,1046,共5页Chinese Journal of Health Laboratory Technology

摘　　要：目的研究哈尔滨医科大学附属第二医院临床分离金葡菌(Staphylococcus aureus,SA)的耐药情况、临床和分子流行病学特征,为控制SA的流行提供依据。方法采用纸片扩散法对临床分离的60株SA进行药敏试验,PCR法检测菌株携带mecA基因和pvl基因以及其他毒素基因的情况,并spa分型。结果 60株SA包括34株耐甲氧西林金黄色葡萄球菌(methicillin-resistant S.aureus,MRSA)(56.7%)和26株对甲氧西林敏感的金黄色葡萄球菌(methicillin sensitive S.aureus,MSSA)(43.3%)。与MSSA比较,MRSA对利福平、左氧氟沙星、莫西沙星、环丙沙星、庆大霉素和四环素等抗菌药物的敏感性显著降低(P<0.05)。共检出携带毒素基因sea 50株,seb 4株,eta 1株,pvl 1株,且均从CA-MSSA中检出,未检出sec、tst、sasX。spa分型结果:MRSA中t030有31株,t748有1株,无法分型2株;MSSA中有16个spa型别,以t078、t571和t1451位列前3位,分别占23.1%、7.7%和7.7%,检出1株新spa基因型t12444。结论 MSSA遗传多样性高,MRSA优势克隆型集中为t030,有必要加强监测和感染防控措施的落实。Objective To investigate the drug resistance and molecular epidemiological characteristics of Staphylococcus aureus（ SA） isolates from the 2nd Affiliated Hospital of Harbin Medical University,so as to provide basis for control of Staphylococcus aureus epidemic. Methods The susceptibility of 60 SA isolates was detected by disk diffusion method. The presence of mecA gene,pvl gene and some toxin genes in these SA isolates were detected by PCR,and the 60 SA isolates were also analyzed by spa typing. Results In the 60 SA isolates,34 strains were methicillin-resistant Staphylococcus aureus（ MRSA,56. 7%） and 26 strains were methicillin-sensitive Staphylococcus aureus（ MSSA,43. 3%）. Compared with MSSA,MRSA were less sensitive to rifampin,levofloxacin,moxifloxacin,ciprofloxacin,tetracycline and gentamicin（ P〉 0.05）. Toxin gene sea was found in 50 strains,seb was found in 4 strains,eta was found in 1 strain,pvl was found in 1 strain,and all were detected from CA-MSSA,while the toxin genes sec,tst,sasX were not detected. spa typing showed that there were 31 strains of t030,1 strain of t748,and two untyped strains in MRSA,while t078,t571 and t1451 were the first three spa types in MSSA,with the proportion of 23. 1%,7. 7% and 7. 7%,respectively. A new spa type t12444 was detected in 1 MSSA strain. Conclusion The MSSA isolates show high genetic diversity. t030 is the most prevalent spa type among clinical MRSA strains,it is necessary to strengthen monitoring and prevention and control measures to reduce SA infection.

关 键 词：金黄色葡萄球菌 spa分型 医院获得性感染 流行病学分析 

分 类 号：R378.11[医药卫生—病原生物学]