猩红热监测病例分离金黄色葡萄球菌病原特征分析  

Pathogenic characteristics of Staphylococcus aureus isolated from patients in the surveillance of scarlet fever

作　　者：赵宇 梁子珊 朱美娟[1] 荆红波[1] 李颖[1] ZHAO Yu;LIANG Zishan;ZHU Meijuan;JING Hongbo;LI Ying(Shunyi District Center for Disease Prevention and Control,Beijing 101300,China;不详)

机构地区：[1]北京市顺义区疾病预防控制中心,101300 [2]河北北方学院

出　　处：《首都公共卫生》2023年第6期370-373,共4页Capital Journal of Public Health

摘　　要：目的了解猩红热样病例中金黄色葡萄球菌(Staphylococcus aureus)的感染情况,为非A组溶血性链球菌感染导致的咽峡炎提供病因线索。方法采集2019—2022年北京市某区猩红热监测病例的咽拭子样本373份并进行金黄色葡萄球菌分离,对分离菌株进行金黄色葡萄球菌A蛋白基因多态性(spa)分型和对12种抗生素的耐药表型检测,分析其分子特征和耐药特征。结果373份咽拭子样本中SA检出率为6.97%(26/373),男性和女性检出率分别为7.43%(15/202)和6.43%(11/171),检出率比较差异无统计学意义(χ^(2)=0.141,P=0.839);金黄色葡萄球菌的检出病例主要在20岁以下人群,<6岁、6~<11岁、11~<16岁、≥16岁4个年龄组金黄色葡萄球菌检出率分别为5.24%(13/248)、11.65%(12/103)、6.25%(1/16)和0(0/6)。分离到的26株金黄色葡萄球菌共分布10个spa型别,构成比前3位为t652(26.92%,7/26)、t309(15.38%,4/26)、t693(11.54%,3/26)和t571(11.54%,3/26)。26株金黄色葡萄球菌对PEN、TET、ERY、OXA、CFX耐药率分别为92.31%(24/26)、23.08%(6/26)、19.23%(5/26)、7.69%(2/26)和7.69%(2/26),分布9种耐药谱,优势耐药谱为PEN单独耐药(50.00%,13/26),其次为PEN+TET联合耐药(19.23%,5/26)和PEN+ERY联合耐药(7.69%,2/26)。多重耐药率为11.54%(3/26)。结论北京市某区猩红热监测病例中金黄色葡萄球菌检出率较高,分离株spa分型分布多样但在短期内呈现一定聚集分布特征,且不同年份具有不同的优势型别。金黄色葡萄球菌分离株对PEN处于高耐药水平而对OXA和CFX处于较低耐药水平。Objective To understand the prevalence of Staphylococcus aureus infection in scarlet fever cases,so as to provide pathongenic evidence for non-group A streptococcal isthmitis.Methods A total of 373 pharyngeal swab samples were collected from patients in the surveillance of scarlet fever in a district of Beijing from 2019 to 2022.The genotype testing with protein A gene polymorphism analysis of Staphylococcus aureus(spa)and phenotype testing of drug resistance to 12 antibiotics were used for isolated strains to analyze the molecular characteristics and drug resistance features.Results The detection rate of Staphylococcus aureus in 373 samples was 6.97%(26/373)and the rates in males and females were 7.43%(15/202)and 6.43%(11/171),respectively.The difference in the rates was not statistically significant(χ^(2)=0.141,P=0.839).Staphylococcus aureus cases were mainly detected in age group under 20 years old.The detection rates of Staphylococcus aureus in age groups of<6 years old,6 to<11 years old,11 to<16 years old and≥16 years old were 5.24%(13/248),11.65%(12/103),6.25%(1/16)and 0(0/6),respectively.The 26 Staphylococcus aureus isolates were divided into 10 spa types.The top three types were t652(26.92%,7/26),t309(15.38%,4/26),t693(11.54%,3/26)and t571(11.54%,3/26).The drug resistance rates of 26 Staphylococcus aureus strains to PEN,TET,ERY,OXA and CFX were 92.31%(24/26),23.08%(6/26),19.23%(5/26),7.69%(2/26)and 7.69%(2/26),respectively.There were nine resistance spectra observed,and the dominant was single resistance to PEN(50.00%,13/26),followed by combined drug resistance to PEN+TET(19.23%,5/26)and to PEN+ERY(7.69%,2/26).The multi-drug resistance rate was 11.54%(3/26).Conclusions The detection rate of Staphylococcus aureus was relatively high among patients in scarlet fever surveillance in this area.The distribution of spa types in isolated strains was diverse but showed certain clustering distribution characteristics in a short period of time with different dominant types in the years.The Staphylococcus aureus i

关 键 词：猩红热 金黄色葡萄球菌 金黄色葡萄球菌A蛋白基因多态性分型 耐药性 

分 类 号：R515.1[医药卫生—内科学]