重症肺炎患者感染耐甲氧西林金黄色葡萄球菌的SCCmec基因分型及预后影响因素分析  

Analysis of SCCmec genotyping and prognostic factors in patients with severe pneumonia infected with methicillin-resistant Staphylococcus aureus

作　　者：陈剑锋[1] 秦恒毅[1] 谢淑芳[1] 胡青[1] CHEN Jian-feng;QIN Heng-yi;XIE Shu-fang;HU Qing(Chenzhou First People's Hospital,Chenzhou 423000,China)

机构地区：[1]郴州市第一人民医院,湖南郴州423000

出　　处：《中国消毒学杂志》2025年第1期46-49,53,共5页Chinese Journal of Disinfection

摘　　要：目的研究重症肺炎患者感染耐甲氧西林金黄色葡萄球菌(MRSA)SCCmec基因分型及其耐药性。方法采用细菌分离鉴定技术和基因检测方法,对某医院174例MRSA感染重症肺炎患者痰液样本进行检测鉴定与分析。结果从174份痰液标本中分离出MRSA 75株,检出率为43.10%;其中,鉴定出SCCmecⅡ型、SCCmecⅢ、SCCmecⅣ型、SCCmecⅤ型和未分型的构成比依次为37.33%、8.00%、44.00%、4.00%和6.67%。分离的MRSA对青霉素、苯唑西林和头孢西丁全部耐药,对万古霉素、利奈唑胺、替考拉宁和替加环素等抗菌药物敏感。机械通气、意识障碍、脏器损害个数≥3个和APACHEⅡ评分等因素为影响患者预后的独立危险因素。结论MRSA感染重症肺炎患者痰液标本中MRSA分离率高达43.10%,MRSA菌株SCCmec基因型以Ⅱ型和Ⅳ型为主,应针对危险因素提出防控措施。Objective To investigate the SCCmec genotype and drug resistance of methicillin-resistant Staphylococcus aureus(MRSA)in patients with severe pneumonia.Methods Bacterial isolation and identification techniques,as well as genetic testing methods,were used to detect,identify and analyze sputum samples from 174 severe pneumonia patients infected with MRSA in a hospital.Results 75 strains of MRSA were isolated from 174 sputum samples,with a detection rate of 43.10%;Among them,the composition ratios of SCCmec II,SCCmec III,SCCmec IV,SCCmec V,and unclassified were 37.33%,8.00%,44.00%,4.00%,and 6.67%,respectively.The isolated MRSA was resistant to penicillin,ampicillin and cefoxitin,but sensitive to antibiotics such as vancomycin,linezolid,teicoplanin and tigecycline.Mechanical ventilation,consciousness disorders,organ damage≥3,and APACHE II score were independent risk factors affecting patient prognosis.Conclusion The isolation rate of MRSA in sputum samples from patients with severe pneumonia infected with MRSA is as high as 43.10%.The SCCmec genotypes of MRSA strains are mainly type II and IV,and prevention and control measures should be proposed based on risk factors.

关 键 词：重症肺炎 耐甲氧西林金黄色葡萄球菌 SCCMEC基因分型 耐药性 预后 

分 类 号：R181.32[医药卫生—流行病学]