社区获得性MRSA感染的危险因素及菌株特征分析  

Research on the risk factors and the strain characteristics of the community-acquired MRSA infection

作　　者：常燕子[1] 崔裕山 李情操[1] 裘莉佩[1] 高国生[2] 

机构地区：[1]宁波市医疗中心李惠利医院检验科,浙江宁波315041 [2]宁波市第二医院,浙江宁波315010

出　　处：《中国卫生检验杂志》2015年第16期2812-2814,2818,共4页Chinese Journal of Health Laboratory Technology

基　　金：宁波市自然科学基金(2012A610189)

摘　　要：目的了解本地区社区获得性MRSA感染的相关危险因素及菌株的毒力和耐药基因特征。方法收集2008年-2013年184例社区金黄色葡萄球菌感染患者资料及相应菌株,统计分析患者年龄、性别、基础疾病、入院史、手术史等因素与MRSA感染的相关性,检测相应菌株的毒力基因(pvl和tst)和SCCmec型别并进行对比分析。结果社区获得性金黄色葡萄球菌感染病例中,MRSA分离率为23.4%,一年前有入院史是社区MRSA感染的高危因素。43株MRSA中,检测到Ⅱ型、Ⅲ型和Ⅳa型3种SCCmec型别,分别占18.6%、27.9%和20.9%,14株(32.6%)不可分型。其中,SCCmec-Ⅲ型与毒力基因pvl,SCCmec-Ⅱ型与毒力基因tst存在相关关系。结论入院史是社区获得性MRSA感染不可忽视的危险因素。Objective To learn the risk factors for community- acquired MRSA infection and the virulence and resistance characteristics of the MRSA isolates. Methods 184 cases and isolates of Staphylococcus aureus infection were collected from 2008 to 2013. Relevance between the factors（ e. g. age,gender,underlying diseases,and history of hospitalization or surgery） and MRSA infection were analyzed. The virulence genes,pvl and tst,and SCCmec genotype were detected and analyzed. Results MRSA infection accounted for 23. 4% of all the community- acquired Staphylococcus aureus cases. The history of hospitalization one year before was the high risk factor for community- acquired MRSA infection. From 43 MRSA isolates,SCCmec- Ⅱ,Ⅲ and Ⅳa genotypes could be detected,which accounted for 18. 6%,27. 9% and 20. 9%. 14（ 32. 6%） couldn＇t be classified. And there were statistical relationship among the genotype SCCmec- Ⅲ and pvl,SCCmec-Ⅱand tst,respectively. Conclusion The history of hospitalization is an important risk factor for community- acquired MRSA infection.

关 键 词：社区获得性感染 耐甲氧西林金黄色葡萄球菌 危险因素 

分 类 号：R378.11[医药卫生—病原生物学]