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
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郝晓柯

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R181.3+2

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陕西省自然科学基金资助项目(2014JM4188)


Characteristics of antimicrobial resistance and molecular epidemiology of Staphylococcus aureus isolated from patients in intensive care units
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    摘要:

    目的了解某院重症监护病房(ICU)金黄色葡萄球菌的耐药特点及分子流行病学特征。方法收集2014年1—12月该院ICU分离的金黄色葡萄球菌,进行细菌鉴定及药物敏感性试验,采用金黄色葡萄球菌A蛋白(spa)分型及多位点序列分型(MLST)方法进行分型。结果160株金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌(MRSA)120株(占75.00%)。MRSA对红霉素、克林霉素、左氧氟沙星的耐药率均>80%;MSSA对头孢唑林敏感,对红霉素、克林霉素、左氧氟沙星的耐药率分别为62.50%、35.00%、10.00%。spa分型和MLST结果显示,120株MRSA主要为ST239t030、ST239t037、ST5t2460 3种型别,其中ST239t030(105株,87.50%)为主要流行菌株,8个ICU均有检出;MSSA存在较多型别,ST59t437仅在神经内科(8株)和消化科(2株)检出,ST6t701、ST398t3625、ST398t1793和ST121t2092分别仅在神经内科(7株)、麻醉科(5株)、神经外科(4株)和心外科(4株)检出。结论该院ICU MRSA分离率较高,以ST239t030克隆株为主,存在医院内流行;不同型别MSSA在各科室内存在流行趋势。

    Abstract:

    ObjectiveTo study the characteristics of antimicrobial resistance and molecular epidemiology of Staphylococcus aureus (S. aureus) in the intensive care units(ICUs) of a hospital. MethodsClinical isolates of S. aureus collected from ICUs between January and December 2014 were identified and performed antimicrobial susceptibility testing, then typed by staphylococcal protein A (spa) typing and multilocus sequence typing (MLST) methods. ResultsOf 160 isolates of S. aureus, 120 (75.00%) were methicillinresistant S. aureus (MRSA). Resistance rates of  MRSA to erythromycin, clindamycin,and levofloxacin were all >80%; methicillinsensitive S. aureus (MSSA) were sensitive to cefazolin, resistance rates to erythromycin, clindamycin, and levofloxacin were 62.50%,35.00%, and 10.00%  respectively. spa typing and MLST results showed that the main types of 120 isolates of MRSA were ST239t030,ST239t037, and ST5t2460, the major epidemic strains were ST239t030 (n=105,87.50%), and were isolated from 8 ICUs; MSSA had more types, ST59t437 were detected only from department of neurology(n=8) and department of digestive diseases(n=2), ST6t701,ST398t3625,ST398t1793, and ST121t2092 were isolated  from departments of neurology(n=7),  anesthesiology(n=5), neurosurgery(n=4),and cardiac surgery(n=4)respectively.  ConclusionIsolation rate of MRSA in ICUs in this hospital is high, ST239t030 is the main type, which prevailed in hospital; different types of MSSA have epidemic trends in various departments.

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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. DOI:10.3969/j. issn.1671-9638.2016.05.002.
XU Xiuli, ZHOU Shan, BAI Lu, et al. Characteristics of antimicrobial resistance and molecular epidemiology of Staphylococcus aureus isolated from patients in intensive care units[J]. Chin J Infect Control, 2016,15(5):294-298. DOI:10.3969/j. issn.1671-9638.2016.05.002.

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  • 收稿日期:2015-12-10
  • 最后修改日期:2016-02-10
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  • 在线发布日期: 2016-05-30
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