某医院儿科感染耐甲氧西林金黄色葡萄球菌及femA、mecC、PVL耐药基因特点  

Characteristics of methicillin-resistant Staphylococcus aureus and the detection of femA,mecC and PVL resistance genes in pediatric infections in a tertiary hospital

作　　者：王洪阁 刘可娜 王天佐 WANG Hong-ge;LIU Ke-na;WANG Tian-zuo(Binzhou Hospital of Traditional Chinese Medicine,Binzhou,Shandong 256613,China;不详)

机构地区：[1]滨州市中医医院检验科,山东滨州256613 [2]辽宁中医药大学中医学(5+3)系,沈阳辽宁110167

出　　处：《中华医院感染学杂志》2021年第16期2512-2516,共5页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(2019512)。

摘　　要：目的探讨某三甲医院儿科感染耐药金黄色葡萄球菌检出特点及femA、mecC、PVL耐药基因表达改变。方法选择2018年1月-2020年3月医院门诊及住院儿科临床标本分离出的金黄色葡萄球菌株149株,将其分为耐甲氧西林金黄色葡萄球菌(MRSA)组及甲氧西林敏感金黄色葡萄球菌(MSSA)组,对检出金黄色葡萄球菌标本来源分布及MRSA组、MSSA组耐药性特点进行比较;比较两组患儿的临床资料及预后情况;采用聚合酶链式扩增反应对菌株DNA中femA、mecC、PVL耐药基因进行检测。结果149株检出金黄色葡萄球菌中痰液标本61株占40.94%,检出率最高;MRSA检出率为35.57%(53/149),MRSA组对克林霉素耐药率高于MSSA组(P<0.05),两组对其余抗菌药物耐药率差异无统计学意义;所有检出金黄色葡萄球菌对万古霉素、替拉考宁、利奈唑胺耐药率均为0;MRSA组及MSSA组femA基因检出率均为100.00%,mecC检出率均为0,PVL检出率差异无统计学意义。MRSA组预后不良发生率高于MSSA组,差异具有统计学意义(P<0.05)。结论本地区SA携带femA、mecC、PVL耐药基因与国内报道无明显差异,MRSA感染患儿预后相对较差,应保持持续关注,为感染防控提供完善的数据。OBJECTIVE To explore the detection characteristics of drug-resistant Staphylococcus aureus and the expression changes of femA,mecC and PVL in a pediatric department of a tertiary hospital.METHODS Total of 149 strains of S.aureus isolated from clinical specimens of outpatients and inpatients from Jan 2018 to Mar 2020 of Binzhou Hospital of Traditional Chinese Medicine were divided into the methicillin-resistant S.aureus(MRSA)group and methicillin-sensitive S.aureus(MSSA)group.The source distribution of specimens detected S.aureus and drug resistance of the strains between the MRSA group and MSSA group were compared.The clinical data and prognosis between the two groups of children were compared.Polymerase chain reaction was used to detect drug resistance genes of fema,mecC and PVL.RESULTS Among 149 SA strains detected,61 strains were detected from pus specimens,accounting for 40.94%,with the highest detection rate.The detection rate of MRSA was 35.57%(53/149);the drug resistance rate to clindamycin in the MRSA group was significantly higher than that in the MSSA group(P<0.05).The drug resistance rates of S.aureus detected to tetracycline,teraconine and linezolid were all 0.The detection rate of femA gene in the MRSA group and the MSSA group were both 100.00%,while he mecC detection rate in both groups were 0,and there was no significant difference in PVL detection rate.CONCLUSION There are no significant differences in SA strains carrying drug resistance genes such as femA,mecC and PVL in this area between our study and domestic reports.The prognosis of children with MRSA infection is relatively poor,and continuous attention should be paid to provide complete data for infection prevention and control.

关 键 词：耐甲氧西林金黄色葡萄球菌 甲氧西林敏感金黄色葡萄球菌 肽聚糖合成因子A 甲氧西林耐药决定因子C 杀白细胞素 

分 类 号：R446.5[医药卫生—诊断学]