李颐, 赵文良, 王海玲, 胡雪明, 蔡明毅, 范惠莹, 阿力, 沈铭华. 医院环境耐甲氧西林金黄色葡萄球菌分子分型和耐药性分析[J]. 上海预防医学, 2018, 30(12): 1016-1019, 1024. DOI: 10.19428/j.cnki.sjpm.2018.18787
引用本文: 李颐, 赵文良, 王海玲, 胡雪明, 蔡明毅, 范惠莹, 阿力, 沈铭华. 医院环境耐甲氧西林金黄色葡萄球菌分子分型和耐药性分析[J]. 上海预防医学, 2018, 30(12): 1016-1019, 1024. DOI: 10.19428/j.cnki.sjpm.2018.18787
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LI Yi, ZHAO Wen-liang, WANG Hai-ling, HU Xue-ming, CAI Ming-yi, FAN Hui-ying, A Li, SHEN Ming-hua. Molecular typing and drug resistance of Methicillin-resistant Staphylococcus aureus isolated from hospital environment[J]. Shanghai Journal of Preventive Medicine, 2018, 30(12): 1016-1019, 1024. DOI: 10.19428/j.cnki.sjpm.2018.18787
Citation: LI Yi, ZHAO Wen-liang, WANG Hai-ling, HU Xue-ming, CAI Ming-yi, FAN Hui-ying, A Li, SHEN Ming-hua. Molecular typing and drug resistance of Methicillin-resistant Staphylococcus aureus isolated from hospital environment[J]. Shanghai Journal of Preventive Medicine, 2018, 30(12): 1016-1019, 1024. DOI: 10.19428/j.cnki.sjpm.2018.18787
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医院环境耐甲氧西林金黄色葡萄球菌分子分型和耐药性分析

Molecular typing and drug resistance of Methicillin-resistant Staphylococcus aureus isolated from hospital environment

    摘要
  • 摘要:
    目的了解医院环境耐甲氧西林金黄色葡萄球菌(MRSA)的分布、耐药性和分子分型情况，为医院感染防控提供依据。
    方法对2014年12月—2015年5月上海市静安区某三级综合性医院监护病房环境中分离的MRSA菌株，采用K-B纸片扩散法进行药敏试验，并采用脉冲场凝胶电泳(PFGE)进行分子分型。
    结果316件标本中检出金黄色葡萄球菌46株，污染率为14.6%；检出MRSA22株，污染率为7.0%。MRSA对头孢呋辛、左氧氟沙星、环丙沙星、氨苄西林/舒巴坦、红霉素、庆大霉素的耐药率均高于甲氧西林敏感的金黄色葡萄球菌(MSSA)，差异均有统计学意义(P值均＜0.01)。14株MRSA经PFGE检测后共分为8个型别，总体相似度在85%的水平。其中2个型别各有4株为同一基因型。
    结论医院环境表面分离的MRSA对β-内酰胺类、喹诺酮类、大环内酯类抗生素存在不同程度耐药，环境中存在MRSA克隆株污染，应加强病人和环境、医务人员和环境之间的感染控制措施。

     

    Abstract:
    ObjectiveTo investigate the prevalence, drug resistance and molecular characteristics of MRSA in hospital environment, so as to provide basis for prevention and control of nosocomial MRSA infection.
    MethodsSpecimens from Dec 2014 to May 2015 were collected from a tertiary hospital in Jing′an District of Shanghai and MRSA strains isolated from hospital environment and characterized by antimicrobial susceptibility testing and pulsed-field gel electrophoresis (PFGE).
    ResultsFrom 316 specimens were detected 46 MRSA strains with contamination rate being 14.6%(46/316).And 22 (7.0%) were detected to be carriers of MRSA on the surfaces of ICU environment.MRSA had higher resistant rate to cefuroxime, levofloxacin, ciprofloxacin, Ampicillin/sulbactam, erythrocin, gentamycin than MSSA, and the difference was statistically significant(P < 0.01).A total of 8 PFGE patterns were identified among the 14 MRSA isolates, which were mostly similar from one clone.
    ConclusionMRSA strains isolated from ICU in this hospital are multi-resistant to β-lactam antibiotics, quinolones and macrolides.There is clonal pollution in the environment.It is necessary to decrease the contamination rates between patients and environment, health care workers and environment, also it is worthwhile to increase the disinfection rate of environment.

     

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