基于多重RT-PCR法探讨某院耐甲氧西林凝固酶阴性葡萄球菌败血症的耐药基因表达研究  

To investigate the expression of drug resistance genes in a hospital of methicillin-resistant coagulase-negative Staphylococcus septicaemia based on multiple RT-PCR

作　　者：杨祥康 陈静 姜雯 占焕平 何凤萍 曾芳 YANG Xiang-kang;CHEN Jing;JIANG Wen;ZHAN Huan-ping;HE Feng-ping;ZENG Fang(Clinical Laboratory,Zhoushan Maternal and Child Health-care Hospital,Zhoushan,Zhejiang 316000,China)

机构地区：[1]舟山市妇幼保健院检验科,浙江舟山316000

出　　处：《中国卫生检验杂志》2020年第8期934-936,940,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的采用多重RT-PCR法检测本院耐甲氧西林凝固酶阴性葡萄球菌败血症的耐药基因表达情况。方法选取2018年1月-2019年1月在本院确诊为葡萄球菌败血症的院内感染患者80例作为研究对象,根据药敏结果分为耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的观察组(n=20)和对照组(n=60),检测MRCNS的耐药基因mecA、ermA/B/C、qacA/B表达,对比2组临床特点、耐药基因表达、药敏结果、分析患者预后不良的危险因素。结果观察组患者最高体温、心率、乳酸、APACHEⅡ评分明显高于对照组,而氧分压、平均动脉压低于对照组(P<0.05);观察组耐药基因mecA、ermA/B/C、qacA/B阳性率均高于对照组患者,上述差异均有统计学意义(P<0.05)。APACHEⅡ评分、A qacA/B阳性、ermA/B/C阳性、mecA阳性是葡萄糖球感染败血症患者死亡的独立危险因素。结论MRCNS感染具有较高的耐药基因携带率,严重影响患者预后,应重点监测。Objective To detect the gene expression of methicillin-resistant coagulase-negative Staphylococcus in our hospital by multiplex RT-PCR.Methods Eighty patients with nosocomial infection diagnosed as Staphylococcal sepsis in our hospital from January 2018 to January 2019 were selected as the study subjects.According to the drug sensitivity results,they were divided into observation group(n=20)and control group(n=60).The expressions of mecA,ermA/B/C and qacA/B genes of MRCNS were detected.The clinical characteristics and drug resistance of the two groups were compared.Gene expression,drug sensitivity and risk factors of poor prognosis were analyzed.Results The highest body temperature,heart rate,lactic acid and APACHE II scores in the observation group were significantly higher than those in the control group,while oxygen partial pressure and average arterial pressure were lower than those in the control group(P<0.05).The positive rates of mecA,ermA/B/C and qacA/B genes in the observation group were significantly higher than those in the control group,with the differences statistically significant(P<0.05).APACHE II scores,A qacA/B/C,respectively.Positive,ermA/B/C and mecA were independent risk factors for death in patients with sepsis caused by globus infection.Conclusion MRCNS infection has a high rate of drug resistance gene carrying,which seriously affects the prognosis of patients and should be monitored.

关 键 词：葡萄球菌 耐药基因 败血症 RT-PCR 

分 类 号：R446.5[医药卫生—诊断学]