社区医院耐苯唑西林金黄色葡萄球菌的分子流行病学调查  

Molecular epidemiological surveillance of MRSA in community hospital

作　　者：徐宁[1] 莫和国[1] 向蓉[1] 吴丽[1] 黄少丽[1] 

机构地区：[1]南方医科大学附属小榄人民医院检验科,广东中山528415

出　　处：《中国卫生检验杂志》2016年第13期1956-1958,1962,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的调查本院2014年7月-12月MRSA分布情况、耐药表型、SCCmec分型及检测PVL基因。方法收集本院2014年下半年MRSA共53株。用VITEK 2鉴定菌株,检测耐药模式,多重PCR检测SCCmec分型,PCR检测PVL基因。结果 MRSA检出率前2位的科室是普外科9株(17.0%)、儿内呼吸科8株(15.1%)。标本类型居前2位的是脓液18株(34.0%)、痰17株(32.1%)。SCCmec分型为Ⅰ型3株、Ⅱ型14株、Ⅲ型25株、Ⅳa型7株、Ⅴ型1株、未分型5株。检出PVL基因阳性株10株。Ⅱ型、Ⅲ型和部分Ⅳa型除对β内酰胺类耐药外,对其他抗生素也多重耐药。结论本院分离的MRSA主要分布在普外科和儿科,标本类型以脓液、痰为主。SCCmec的型别以Ⅱ型、Ⅲ型为主,存在对非β内酰胺类抗生素耐药的SCCmecⅣ型菌株。应加强抗生素的合理使用,减少多重耐药菌的产生。Objective To investigate the MRSA distribution,drug-resistance pattern,the genotypes of Staphylococcal cassette chromosome mec（ SCCmec） typing and PVL gene from our hospital in the second half year. Methods 53 strains of MRSA were collected from our hospital in July-December 2014. VITEK 2 was used to identify the isolates and detect the resistance pattern. SCCmec typing was determined by multiplex PCR,PVL gene was detected by PCR. Results 9 MRSA strains（ 17. 0%）were detected in surgical department,followed by 8 strains（ 15. 1%） in paediatric department. 18 MRSA strains（ 34. 0%） were detected in pus,followed by 17 strains（ 32. 1%） in sputum. SCCmecⅠ was identified in 3 strains,SCCmecⅡ in 14 strains,SCCmec Ⅲ in 25 strains,SCCmec Ⅳa in 7 strains and SCCmec Ⅴ in 1 strain,while 5 strains were none-typable. 10 strains were PVL positive. SCCmecⅡ,SCCmec Ⅲ and some SCCmec Ⅳa strains were resistant to beta-lactam antimicrobials and also multi-resistant to other antimicrobials. Conclusion MRSA strains are mainly distributed in surgical department and paediatric department,the common sample types are pus and sputum. SCCmecⅡ and SCCmec Ⅲ are the major genotypes in our hospital.There are some SCCmec Ⅳ strains that resistant to non-beta-lactam antimicrobials. The reasonable use of antimicrobial should be enhanced to reduce multidrug resistance.

关 键 词：社区医院 分子流行病学 金黄色葡萄球菌 杀白细胞素 葡萄球菌染色体盒 

分 类 号：R181.3[医药卫生—流行病学]