热带病与寄生虫学

热带病与寄生虫学 ›› 2023, Vol. 21 ›› Issue (3): 174-177.doi: 10.3969/j.issn.1672-2302.2023.03.012

• 临床研究 • 上一篇    下一篇

金黄色葡萄球菌分离株在住院患者中的临床分布及耐药性分析

徐贝(), 李萍, 张青松()   

  1. 宣城市中心医院检验科，安徽宣城242000
  • 收稿日期:2023-03-22 出版日期:2023-06-20 发布日期:2023-07-06
  • 通信作者: 张青松，E-mail: qszhang07@163.com
  • 作者简介:徐贝，男，本科，主管技师，研究方向：临床微生物学检验。E-mail: xubei1989712@163.com
  • 基金资助:
    宣城市卫生健康科研项目(XCWJ2022061)

Clinical distribution and drug resistance of Staphylococcus aureus isolates from inpatients

XU Bei(), LI Ping, ZHANG Qing-song()   

  1. Department of Laboratory Medicine of XuanCheng City Central Hospital, Xuancheng 242000, Anhui Province, China
  • Received:2023-03-22 Online:2023-06-20 Published:2023-07-06
  • Contact: ZHANG Qing-song, E-mail: qszhang07@163.com

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摘要：

目的 探讨某医院住院患者感染金黄色葡萄球菌分离株的临床分布特征及耐药状况，为临床抗感染治疗提供科学依据。方法 选取2021年9月—2023年3月宣城市中心医院收治的金黄色葡萄球菌感染患者作为研究对象，通过聚合酶链反应（polymerase chain reaction，PCR）检测金黄色葡萄球菌的耐药基因mecA和杀白细胞素（Panton-Valentine leukocidin，PVL）基因，采用SPSS 20.0和WHONET 5.6软件分析金黄色葡萄球菌感染的临床分布特征及耐药状况。结果 共有133例金黄色葡萄球菌感染患者纳入分析，单个科室中占比前两位的是呼吸与危重症医学科（21.8%，29/133）和重症医学科（18.8%，25/133）。感染主要类型为皮肤疖痈、褥疮类感染，占47.4%（63/133）；上、下呼吸道感染分别占23.3%（31/133）、13.5%（18/133）。药敏结果显示金黄色葡萄球菌对万古霉素、利奈唑胺、替加环素、呋喃妥因及利福平敏感率为100.0%，对青霉素的耐药率最高（88.0%），其后为红霉素、克林霉素，耐药率分别为34.6%、30.1%。耐甲氧西林金黄色葡萄球菌检出率为23.3%（31/133）。31株耐甲氧西林金黄色葡萄球菌中有30株携带耐药基因mecA，6株携带PVL基因，其中5株同时携带mecA和PVL基因。结论 宣城市中心医院住院患者感染金黄色葡萄球菌主要来自呼吸与危重症医学科和重症医学科，对青霉素、红霉素、克林霉素等药物耐药率较高，应根据药敏试验合理规范地选择抗菌药物治疗感染。

关键词: 金黄色葡萄球菌, 临床特征, 耐药性

Abstract:

Objective To investigate the patterns of clinical distribution and drug resistance of Staphylococcus aureus strains isolated from hospitalized patients in a hospital for scientific evidence in the treatment of the infection in clinic. Methods Patients with Staphylococcus aureus infection treated in XuanCheng City Central Hospital were included from September 2021 to March 2023 as study subjects. The resistance genes mecA and Panton-Valentine leukocidin (PVL) of Staphylococcus aureus were detected by polymerase chain reaction (PCR), SPSS 20.0 and WHONET 5.6 software was used to analyze the clinical distribution patterns and drug resistance status of Staphylococcus aureus infection. Results A total of 133 patients with Staphylococcus aureus infections were included in the analysis. Among single department, the top two departments were Pulmonary and Critical Care Medicine (21.8%, 29/133) and the Intensive Care Unit (18.8%, 25/133). The major types of infection were skin furuncle & carbuncle and bedsore (47.4%, 63/133) as well as involvement of upper respiratory tract (23.3%, 31/133) and lower respiratory tract (13.5%, 18/133). The drug susceptibility tests showed that Staphylococcus aureus was 100.0% sensitive to vancomycin, linezolid, tigecycline, nitrofurantoin and rifampicin. The resistance rate to penicillin was the highest, 88.0%, followed by crythromycin and clindamycin, 34.6% and 30.1%, respectively. The detection rate of methicillin-resistant Staphylococcus aureus (MRSA) was 23.3% (31/133). Of 31 MRSA strains, 30 carried mecA gene, 6 carried PVL gene, and 5 carried both mecA and PVL genes. Conclusion Staphylococcus aureus infection in hospitalized patients in XuanCheng City Central Hospital primarily occurred in patients from Pulmonary and Critical Care Medicine and Intensive Care Unit. The rate of resistance to penicillin, erythromycin, clindamycin and other antibiotics was high, antibiotics should be rationally prescribed and standardized according to the drug susceptibility test results in clinical management of the infection.

Key words: Staphylococcus aureus, Clinical features, Drug resistance

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