耐甲氧西林金黄色葡萄球菌临床分布、耐药性及初步的分型分析研究  

STUDY ON INFECTION DISTRIBUTION,DRUG RESISTANCE AND PRELIMINARY PHENOTYPIC ANALYSIS OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS

作　　者：张微[1] 蒋瑞萍 高伟利[2] 单坤 田丽君[1] 李会青 赵连春[4] 赵振军[4] Zhang Wei;Jiang Ruiping;Gao Weili(Baoding First Central Hospital,Baoding 071028,China;不详)

机构地区：[1]河北省保定市第一中心医院,071028 [2]石家庄市疾病预防控制中心 [3]河北大学附属医院 [4]河北以岭医院

出　　处：《中国煤炭工业医学杂志》2020年第5期473-476,共4页Chinese Journal of Coal Industry Medicine

基　　金：河北省卫健委科研基金项目青年科技课题(编号:20150402);河北省卫健委科研基金项目课题(编号:20150717);河北省医学科学研究重点课题计划(编号:20180460)。

摘　　要：目的了解某医院耐甲氧西林金黄色葡萄球菌(MRSA)的感染分布及耐药特点,为临床合理使用抗菌药物、有效防控MRSA感染蔓延提供依据。方法采用Vitek2 Compact全自动微生物鉴定仪进行菌株鉴定及药物敏感试验,分析2015年1月—2017年12月自某医院分离出的耐甲氧西林金黄色葡萄球菌菌株的耐药情况,结果按最新版美国临床实验室标准化协会(CLSI)更新文件标准判定;基于上述菌株的抗菌谱特征,使用BioNumerics软件对其进行聚类分析,进而获得这些菌株初步的表型分型分析结果。结果2015年—2017年某医院共检出MRSA阳性患者111例,最常出现在痰液标本中,占各种标本的49.5%,其次是血液、分泌物、尿液。药敏试验结果显示入组本课题的MRSA对抗菌药物表现为多重耐药,未发现对万古霉素、利奈唑胺、替加环素耐药株。聚类分析结果显示,这些菌株可大致分为19型,其中37株菌属于A1型。结论耐甲氧西林金黄色葡萄球菌感染发生率较高,应及早进行病原学检查、药敏试验及分型分析研究,科学合理地选用抗生素,及时消毒、隔离,采取有效措施防止MRSA在医院环境的产生和传播。Objective To investigate the infection distribution and drug resistance of methicillin-resistant Staphylococcus aureus(MRSA)in the hospital,to provide basis for clinical rational use of antibiotics,and to find an effective way to prevent and control the spread of MRSA infection.Methods Vitek 2 Compact automatic microorganism was adopted in train identification and drug sensitivity test.The drug resistance of methicillin-resistant Staphylococcus aureus strains isolated from a hospital from January 2015 to December 2017 was analyzed.The results were determined according to the latest version of the American Society for clinical laboratory standardization(CLSI).Based on the antimicrobial spectrum characteristics of the above strains,the bionumerics software was used for cluster analysis,and then the preliminary phenotypic typing analysis of these strains was obtained result.Results one hundred and eleven cases of MRSA positive patients were detected in a hospital from 2015 to 2017.The most common cases were sputum samples,accounting for 49.5%of all kinds of samples,followed by blood,secretion and urine.The results of drug sensitivity test showed that MRSA was multi-resistant to antibiotics,and no drug-resistant strains to vancomycin,linezolid and tigecycline were found.Cluster analysis showed that these strains could be roughly divided into 19 types,37 of which belonged to A1 type.Conclusion A total of 111 methicillin-resistant Staphylococcus aureus(MRSA)positive patients were detected from 2015 to 2017,which were most commonly found in sputum samples,accounting for 49.5%of all kinds of samples,followed by blood,secretions and urine.The results of drug sensitivity test showed that the Staphylococcus aureus strains from the hospital were multi-drug resistant for antibiotics.No strains resistant to vancomycin,linazolamine and tegacycline were found.Based on the characteristics of the antibacterial spectrum of the above strains,the cluster analysis was carried out by using BioNumerics software,and the preliminary pheno

关 键 词：耐甲氧西林金黄色葡萄球菌 菌群分布 耐药性 感染控制 细菌分型 

分 类 号：R446.5[医药卫生—诊断学]