化脓性感染金黄色葡萄球菌耐药性及分子流行型别分析
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摘要
目的分析2017年上半年西京医院化脓性感染金黄色葡萄球菌的耐药性及分子流行型别,为临床合理用药提供依据。方法收集2017年1—6月分离自化脓性感染患者脓性分泌物样本的金黄色葡萄球菌,采用Vitek 2 Compact全自动微生物鉴定系统进行菌株鉴定及药物敏感性试验,采用多位点序列分型(MLST)联合spa分型方法进行分子流行病学分型。结果共分离金黄色葡萄球菌171株,其中社区感染113株,医院感染58株。医院感染耐甲氧西林金黄色葡萄球菌(MRSA)分离率(62.07%)明显高于社区感染(30.97%)。分子分型结果显示,医院感染和社区感染MRSA分别以ST239-t030和ST239-t037为主。结论 2017年上半年西京医院化脓性感染金黄葡萄球菌医院感染和社区感染在多个方面存在明显差异。MRSA克隆型别相对比较集中,医院感染存在院内播散现象。应加强医院感染控制力度,降低医院感染发生率。
Objective To analyze the drug resistance and molecular epidemiology of Staphylococcus aureus with suppurative infection in the first half of 2017,and to provide a reference for the rational use of antibiotics.Methods The clinical isolates of Staphylococcus aureus with suppurative infection were collected from January to June,2017. Identi?cation and drug susceptibility test were performed by Vitek 2 Compact automatic microbial identification system. The molecular epidemiology of Staphylococcus aureus was analyzed by spa typing and multilocus sequence typing(MLST). Results A total of 171 isolates of Staphylococcus aureus were isolated.There were 113 isolates from community infection and 58 isolates from nosocomial infection. The methicillin-resistant Staphylococcus aureus(MRSA) isolation rate in nosocomial infection group was 62.07%,which was higher than that in community infection group(30.97%). The results of molecular typing showed that the main types in nosocomial and community infection groups were ST239-t030 and ST239-t037,respectively. Conclusions At Xijing Hospital in the ?rst half of 2017,there are differences for Staphylococcus aureus between nosocomial and community infection groups. MRSA clones are relatively concentrated,and nosocomial infection group has spread phenomenon.The control of nosocomial infection should be strengthened,in order to reduce the incidence of nosocomial infection.
Objective To analyze the drug resistance and molecular epidemiology of Staphylococcus aureus with suppurative infection in the first half of 2017,and to provide a reference for the rational use of antibiotics.Methods The clinical isolates of Staphylococcus aureus with suppurative infection were collected from January to June,2017. Identi?cation and drug susceptibility test were performed by Vitek 2 Compact automatic microbial identification system. The molecular epidemiology of Staphylococcus aureus was analyzed by spa typing and multilocus sequence typing(MLST). Results A total of 171 isolates of Staphylococcus aureus were isolated.There were 113 isolates from community infection and 58 isolates from nosocomial infection. The methicillin-resistant Staphylococcus aureus(MRSA) isolation rate in nosocomial infection group was 62.07%,which was higher than that in community infection group(30.97%). The results of molecular typing showed that the main types in nosocomial and community infection groups were ST239-t030 and ST239-t037,respectively. Conclusions At Xijing Hospital in the ?rst half of 2017,there are differences for Staphylococcus aureus between nosocomial and community infection groups. MRSA clones are relatively concentrated,and nosocomial infection group has spread phenomenon.The control of nosocomial infection should be strengthened,in order to reduce the incidence of nosocomial infection.
引文
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[4]崔兰卿,李耘,薛峰,等.苯唑西林敏感甲氧西林耐药金黄色葡萄球菌的分子流行病学及耐药性分析[J].中国临床药理学杂志,2015,31(11):912-915.
[5]张欣,喻华,黄湘宁.2011-2015年四川省金黄色葡萄球菌对万古霉素及利奈唑胺耐药性变迁[J].中国感染控制杂志,2017,16(9):807-809.
[6]WANG L J,DONG F,QIAN S Y,et al.Clinical and molecular epidemiology of invasive Staphylococcus aureus infections in Chinese children:a single-center experience[J].Chin Med J(Engl),2017,130(23):2889-2890.
[7]徐修礼,周珊,白露,等.ICU患者分离金黄色葡萄球菌的耐药性及分子流行病学特征[J].中国感染控制杂志,2016,15(5):294-298.
[8]HE W,CHEN H,ZHAO C,et al.Population structure and characterisation of Staphylococcus aureus from bacteraemia at multiple hospitals in China:association between antimicrobial resistance,toxin genes and genotypes[J].Int JAntimicrob Agents,2013,42(3):211-219.
[9]袁挺,应春妹.成人和儿童金黄色葡萄球菌感染分子流行病学研究[J].检验医学,2015,30(11):1119-1124.
[10]KONG H,FANG L,JIANG R,et al.Distribution of sasX,pvl,and qacA/B genes in epidemic methicillinresistant Staphylococcus aureus strains isolated from East China[J].Infect Drug Resist,2018,11:55-59.
[2]Clinical and Laboratory Standards Institute.Performance standards for antimicrobial susceptibility testing[S].M100-S24,CLSI,2016.
[3]张静华,袁应华,刘妍,等.2种表型试验检测葡萄球菌诱导型克林霉素耐药的评估及基因分析[J].检验医学,2015,30(12):1238-1242.
[4]崔兰卿,李耘,薛峰,等.苯唑西林敏感甲氧西林耐药金黄色葡萄球菌的分子流行病学及耐药性分析[J].中国临床药理学杂志,2015,31(11):912-915.
[5]张欣,喻华,黄湘宁.2011-2015年四川省金黄色葡萄球菌对万古霉素及利奈唑胺耐药性变迁[J].中国感染控制杂志,2017,16(9):807-809.
[6]WANG L J,DONG F,QIAN S Y,et al.Clinical and molecular epidemiology of invasive Staphylococcus aureus infections in Chinese children:a single-center experience[J].Chin Med J(Engl),2017,130(23):2889-2890.
[7]徐修礼,周珊,白露,等.ICU患者分离金黄色葡萄球菌的耐药性及分子流行病学特征[J].中国感染控制杂志,2016,15(5):294-298.
[8]HE W,CHEN H,ZHAO C,et al.Population structure and characterisation of Staphylococcus aureus from bacteraemia at multiple hospitals in China:association between antimicrobial resistance,toxin genes and genotypes[J].Int JAntimicrob Agents,2013,42(3):211-219.
[9]袁挺,应春妹.成人和儿童金黄色葡萄球菌感染分子流行病学研究[J].检验医学,2015,30(11):1119-1124.
[10]KONG H,FANG L,JIANG R,et al.Distribution of sasX,pvl,and qacA/B genes in epidemic methicillinresistant Staphylococcus aureus strains isolated from East China[J].Infect Drug Resist,2018,11:55-59.
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