引起压疮感染的金黄色葡萄球菌生物膜形成情况及耐药性分析  

Analysis of biofilm formation and drug resistance of Staphylococcus aureus causing pressure ulcer infection

作　　者：刘可 张成敏[1] 柯为 李志恒[1] 王丽华[2] LIU Ke;ZHANG Chengmin;KE Wei;LI Zhiheng;WANG Lihua(Emergency Department,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China;Health Management Center,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院急诊科,重庆400010 [2]重庆医科大学附属第二医院健康管理中心,重庆400010

出　　处：《国际检验医学杂志》2024年第10期1171-1174,1179,共5页International Journal of Laboratory Medicine

基　　金：重庆市科卫联合医学科研项目面上项目(2021MSXM047)。

摘　　要：目的 了解该院压疮感染患者标本中分离的金黄色葡萄球菌的人群分布、生物膜形成情况及耐药情况等流行病学特征,为临床提供重要依据。方法 2019年5月至2022年5月该院共收集到与压疮感染相关的金黄色葡萄球菌126株,采用Vitek MS质谱仪进行细菌鉴定,药敏试验采用纸片扩散法(K-B法),按美国临床实验室标准化协会2016-M100的标准进行药敏结果分析,用结晶紫染色法检测金黄色葡萄球菌生物膜并对生物膜形成能力进行判定,生物膜中分别加入葡萄糖和银离子粉末,观察其对生物膜形成的影响。结果 该院共收集到与压疮感染相关的金黄色葡萄球菌126株,各年龄段及各级压疮均有检出。形成生物膜的菌株占73.00%,其中Ⅳ期压疮分离的菌株形成生物膜的菌株比例(81.81%)高于其他分期(Ⅱ、Ⅲ期)分离的菌株(63.33%),差异有统计学意义(P<0.05);不同生物膜形成能力的菌株对青霉素G、四环素、环丙沙星、磺胺甲噁唑/甲氧苄啶的耐药率较高,对替考拉宁、左氧氟沙星的耐药率较低,未检出对万古霉素耐药的革兰阳性菌,不同生物膜级别金黄色葡萄球菌的耐药性比较,差异无统计学意义(P>0.05);11.10 mmol/L葡萄糖可促进生物膜的形成,10.00μg/mL银离子抗菌凝胶对生物膜的形成有一定抑制作用。结论 导致Ⅳ期压疮感染的金黄色葡萄球菌生物膜形成的能力较强,生物膜的形成与压疮的分期进程有一定的关系;产生物膜的金黄色葡萄球菌的抗菌药物耐药性与生物膜的级别无明显关系;使用银离子和降低血糖水平对生物膜形成有一定的抑制作用。Objective To investigate the population distribution,biofilm formation and drug resistance of Staphylococcus aureus isolated from pressure ulcers infected patients in the hospital,and to provide important clinical evidence.Methods From May 2019 to May 2022,a total of 126 strains of Staphylococcus aureus related to pressure ulcer infections were collected in the hospital.The bacteria were identified by Vitek MS mass spectrometer,and the drug susceptibility test was performed by disk diffusion method(K-B method).The drug susceptibility results were analyzed according to the standards of the American Association for Clinical Laboratory Standardization(ACLA),2016-M100.The crystal violet staining method was used to detect the biofilm of Staphylococcus aureus and determine its formation ability.Glucose and silver ion powder were added to the biofilm respectively,and their effects on biofilm formation were observed.Results From May 2019 to May 2022,126 strains of Staphylococcus aureus related to pressure ulcer infection were collected from the hospital.Pressure ulcer was detected at all ages and levels.The proportion of strains forming biofilm was 73.00%,and the proportion of strains forming biofilm was 81.81%in the strain isolated from stageⅣpressure ulcer,which was higher than that in the strain isolated from other stages(ⅡandⅢ)(63.33%),and the differences were statistically significant(P<0.05).Strains with different biofilm formation ability had higher resistance rates to penicillin G,tetracycline,ciprofloxacin,sulfamethoxazole/trimethoprim,but lower resistance rates to teicoplanin and levofloxacin.No Gram-positive bacteria resistant to vancomycin were detected.There were no significant differences in drug resistance of Staphylococcus aureus in different biofilm levels(P>0.05).11.10 mmol/L glucose could promote the formation of biofilm,10.00μg/mL silver ion antibacterial gel could inhibit the formation of biofilm.Conclusion The biofilm formation ability of Staphylococcus aureus to cause stageⅣpressure ulcer

关 键 词：压疮感染 金黄色葡萄球菌 生物膜 耐药 

分 类 号：R446.5[医药卫生—诊断学] R632.1[医药卫生—临床医学]