国内耐甲氧西林金黄色葡萄球菌耐消毒剂基因特征Meta分析
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倪俊

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R378.1+1R181.3+2

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上海市卫生局科研基金(20134489)


Metaanalysis on the features of disinfectantresistant genes in methicillinresistant Staphylococcus aureus in China
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    摘要:

    目的采用Meta分析,综合评价中国耐甲氧西林金黄色葡萄球菌(MRSA)耐消毒剂基因特征。方法计算机检索中国知网(CNKI)、万方医学网、PubMed、EMbase等数据库,查找中国MRSA耐消毒剂基因特征的相关文献,按照统一的纳入与排除标准筛选文献后,采用R 3.1.1软件、RevMan 5.3软件进行Meta分析。结果共纳入42篇文献,我国16个省(直辖市)的2 671株 MRSA 耐消毒剂基因情况。Meta分析结果显示:qacA/B、qacC、qacJ和norA基因的合并检出率分别为28.03%(95%CI:20.03%~36.48%)、8.94%(95%CI:1.27%~22.49%)、17.74%(95%CI:2.25%~43.39%)和17.90%(95%CI:0.00%~76.38%)。qacEΔ1、qacG、qacH的检出率均为0。中国淮河以南、以北地区qacA/B基因的合并检出率分别为27.12%(95% CI:19.03%~36.06%)和30.14%(95%CI:13.11%~50.63%),南北地区差异无统计学意义(Z=0.59,P>0.05)。东部、中部、西部经济区域的qacA/B基因的合并检出率分别为29.95%(95%CI:21.85%~38.73%)、22.65%(95% CI:10.08%~38.47%)和26.94%(95%CI:3.78%~60.95%),组间差异均无统计学意义(P>0.05)。医院获得性MRSA与社区获得性MRSA qacA/B基因检出率比较,差异无统计学意义[OR及95%CI为0.69(0.14~3.31),P=0.64]。MRSA qacA/B基因检出率高于甲氧西林敏感金黄色葡萄球菌(MSSA)[OR及95%CI为4.99(3.53~7.06),P<0.01]。结论中国MRSA耐消毒剂基因检出率高,MRSA耐消毒剂基因是一个常见且严重的问题,应加强耐消毒剂基因的监测,合理使用消毒剂。

    Abstract:

    ObjectiveTo evaluate the features of disinfectantresistant genes in methicillinresistant Staphylococcus aureus (MRSA) in China through Metaanalysis.MethodsLiteratures about features of disinfectantresistant genes in MRSA were searched from  China National Knowledge Infrastructure(CNKI), Wanfang Med Online, PubMed, and Excerpta  Medica Database (EMbase) through  computerized   retrieval system, literatures were selected according to standard inclusion and exclusion criteria, Metaanalysis was performed using R3.1.1 software and RevMan 5.3 software.ResultsA total of 42 literatures were included, involving disinfectantresistant genes of 2 671 strains of MRSA from 16 provinces (municipalities) in China. The overall detection rate of qacA/B, qacC, qacJ and norA was 28.03%(95%CI: 20.03%-36.48%), 8.94%(95%CI: 1.27%-22.49%), 17.74%(95%CI: 2.25%-43.39%), and 17.90%(95%CI: 0.00%-76.38%) respectively. The detection rates of qacEΔ1, qacG, and qacH were 0.00%. The overall detection rate of qacA/B of the southern and northern China areas was 27.12% (95%CI: 19.03%-36.06%) and 30.14% (95%CI: 13.11%-50.63%) respectively, there was no statistical difference between two areas (Z=0.59, P>0.05). The overall detection rate of qacA/B in the eastern, central and western economic region was 29.95% (95%CI: 21.85%-38.73%), 22.65% (95%CI: 10.08%-38.47%), and 26.94% (95%CI: 3.78%-60.95%) respectively, there was no statistical difference among these regions (P>0.05). The detection rates of qacA/B in hospitalacquired (HA)MRSA and communityacquired (CA)MRSA were not statistically different (OR and 95%CI=0.69[0.14-3.31], P=0.64). The detection rate of qacA/B in MRSA was  higher than those in methicillinsensitive Staphylococcus aureus (MSSA) (OR and 95%CI=4.99[3.53-7.06],P<0.01). ConclusionDetection rate of disinfectantresistant genes in MRSA is high in China, which is common and serious , monitoring on disinfectantresistant genes  should be enhanced, disinfectants should be used rationally.

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倪俊,许献荣,陈瑞彩.国内耐甲氧西林金黄色葡萄球菌耐消毒剂基因特征Meta分析[J]. 中国感染控制杂志,2015,14(3):149-158. DOI:10.3969/j. issn.1671-9638.2015.03.002.
NI Jun, XU Xianrong, CHEN Ruicai. Metaanalysis on the features of disinfectantresistant genes in methicillinresistant Staphylococcus aureus in China[J]. Chin J Infect Control, 2015,14(3):149-158. DOI:10.3969/j. issn.1671-9638.2015.03.002.

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  • 收稿日期:2014-08-28
  • 最后修改日期:2014-11-02
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  • 在线发布日期: 2015-03-30
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