金黄色葡萄球菌标本分布及耐药情况分析  

Epidemiological study on Staphylococcus aureus

作　　者：丁新玲 李曼 DING Xin-ling;LI Man(School of Basic Medical Sciences,Chifeng University,Chifeng 024000,Innerinner Mongolia,China)

机构地区：[1]赤峰学院基础医学院,内蒙古赤峰024000

出　　处：《中国病原生物学杂志》2022年第12期1442-1445,共4页Journal of Pathogen Biology

摘　　要：目的 了解金黄色葡萄球菌对抗菌药物的耐药状况,为临床抗感染治疗提供依据。方法 收集2018年1月至2020年12月某三甲医院门诊及住院患者的痰、分泌物、脓液、血液等临床标本检验分离获取金黄色葡萄球菌,用AST-GP67药敏鉴定卡对其进行14种抗生素的药敏试验。采用头孢西丁纸片K-B琼脂扩散法进行测定MRSA,使用PCR技术耐药基因进行检测并进行分组分析。结果 临床标本分离出金黄色葡萄球菌517株,其中菌株来自痰液标本211株(40.81%),脓液标本90株(17.41%),创面分泌物标本75株(14.51%),血液标本71株(13.73%),阴道分泌物标本16株(3.09%),尿液标本13株(2.51%),引流液标本12株(2.32%),导管尖端标本7株(1.35%),前列腺液标本5株(0.97%),其他部位标本17株(3.30%)。MRSA共计检出257株,占金黄色葡萄球菌的49.71%。其中,2018年度检出率为53.92%(110/204株),2019年度检出率为45.77%(65/142株),2020年度检出率为47.95%(82/171株)。在被检测的14种抗菌药物中,青霉素和红霉素的耐药率最高,万古霉素、利奈唑胺、替考拉宁和喹诺普汀/达福普汀的敏感率最高,均为100%。mecA、tetM、aac(6′)/aph(2′)、aph3′-Ⅲ和qacA/B的携带率在MRSA与MSSA组间比对差异有统计学意义(P<0.05)。结论 临床分离金黄色葡萄球菌中MRSA菌株检出比较高,3年来检出比浮动较小,临床治疗金黄色葡萄球菌感染应根据药敏试验结果规范使用抗菌药物,同时加强对MRSA的耐药性监测,延缓金黄色葡萄球菌耐药性的产生。Objective To understand the drug resistance of Staphylococcus aureus to antibiotics,so as to provide basis for clinical anti infection treatment.Method The sputum,secretion,pus,blood and other clinical samples of outpatients and inpatients in a third class hospital from January 2018 to December 2020 were collected,tested and isolated to obtain S.aureus,the drug sensitivity test of 14 antibiotics was carried out with AST-GP67 drug sensitivity identification card.MRSA was determined by cefoxitin disk K-B agar diffusion method,the drug resistance gene of MRSA were detected and analyzed by PCR.Result From January 2018 to December 2020,517 strains of S.aureus were isolated from clinical specimens,among them,211 strains(40.81%) came from sputum specimens,90 strains(17.41%) came from pus specimens,75 strains(14.51%) wound secretion specimens,71 strains(13.73%) came from blood samples,16 strains(3.09%) came from vaginal secretions,13 strains(2.51%) came from urine samples,12 strains(2.32%) came from drainage fluid samples,7 strains(1.35%) came from catheter tip specimens,5 strains(0.97%) came from prostatic fluid specimens,17 strains(3.30%) came from other parts specimens.257 strains MRSA were detected,accounting for 49.71% of S.aureus.The detection rate was 53.92%(110/204 strains) in 2018,45.77%(65/142 strains) in 2019 and 47.95%(82/171 strains) in 2020.Among the 14 antibiotics tested,the drug resistance rates of penicillin and erythromycin were the highest,and the sensitivity rates of nitrofurantoin,vancomycin,linezolid,teicoplanin and quinoptin/dafuptin were the highest,all of which were 100%.There were significant differences in the carrying rates of mecA、tetM、aac(6′)/aph(2′)、aph3′-Ⅲ and qacA/B between MRSA and MSSA components(P<0.05).Conclusion The detection of MRSA strains in clinical isolated S.aureus is relatively high,and the fluctuation of detection ratio in the past three years is small.In the clinical treatment of S.aureus infection,antibiotics should be standardized according to the results of

关 键 词：金黄色葡萄球菌 耐药性 耐药基因 

分 类 号：R378[医药卫生—病原生物学]