老年患者耐甲氧西林金黄色葡萄球菌流行病学及多位点序列分型研究  

Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in aged patients and multilocus sequence typing

作　　者：赵雪松[1] 吕岩[1] 张斌[1] 任明[1] 单微 

机构地区：[1]齐齐哈尔医学院附属第二医院检验科,黑龙江齐齐哈尔161006

出　　处：《中华医院感染学杂志》2017年第23期5296-5299,共4页Chinese Journal of Nosocomiology

基　　金：黑龙江省教育厅基金资助项目(12531807)

摘　　要：目的研究老年患者耐甲氧西林金黄色葡萄球菌(MRSA)的流行病学及多位点序列分型。方法随机选取医院检验科2016年5月-2017年5月间收集老年患者临床样本分离MRSA菌株30株,分别进行药敏鉴定试验,建立多位点序列分型(MLST)方法并检测染色体7个管家基因,测序结果与MLST数据库网站已有序列比对,进行聚类分析,统计克隆系及ST菌株亲缘关系发育树,并分析MLST耐药性影响因素。结果 MRSA菌株分2大集群A和B,A群由USA100和USA800型组成,B群由USA300和USA700型菌株组成;所有分离菌株均为耐苯唑西林、阿莫西林/克拉维酸菌株;10株耐药菌对万古霉素的最低抑菌浓度(MIC)>1μg/mL;Logistic回归分析结果显示,PVL阳性与万古霉素MIC增加存在显著相关性(P<0.05)。结论本研究数据表明老年患者MRSA分离株均为耐苯唑西林、阿莫西林/克拉维酸菌,针对老年患者临床用药时,需考虑相关影响因素进行防控。OBJECTIVE To investigate the epidemiology of methicillin-resistant Staphylococcus aureus（MRSA）in aged patients and multilocus sequence typing（MLST）.METHODS A total of 30 cases of clinically isolated MRSA strains from samples of aged patients were randomly selected,and drug susceptibility test was carried out.Multilocus sequence typing method was established,and 7 housekeeping genes on chromosome were detected.Sequencing results were compared with the MLST database site sequence,and cluster analysis was carried out.The clones and ST strains kinship phylogenetic tree was analyzed,and risk factors of MLST resistance were analyzed.RESULTS MRSA strains were mainly in 2 large clusters：A and B.A group aonsisted of by the USA100 and USA800,B group consisted of USA300 and USA700 strains.All isolates were resistant to oxacillin,amoxicillin/clavulanate strains.The minimum inhibitory concentration（MIC）of 10 strains of drug-resistant bacteria was greater than 1μg/mL.Logistic regression analysis showed that there was a significant correlation between PVL positive and vancomycin MIC increase（P0.05）.CONCLUSIONOur data indicate that MRSA isolates from aged patients are resistant to oxacillin,amoxicillin/clavulanic acid bacteria,and in view of the clinical use of drugs in aged patients,we should consider the related risk factors for prevention and control.

关 键 词：耐甲氧西林金黄色葡萄球菌 流行病学 多位点序列分型 杀白细胞毒素 老年患者 

分 类 号：R378.1[医药卫生—病原生物学]