Clinical distribution and drug resistance of Staphylococcus aureus isolates from inpatients

doi:10.3969/j.issn.1672-2302.2023.03.012

Abstract

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

CLC Number:

R378.1+1

XU Bei, LI Ping, ZHANG Qing-song. Clinical distribution and drug resistance of Staphylococcus aureus isolates from inpatients[J]. Journal of Tropical Diseases and Parasitology, 2023, 21(3): 174-177.

Figures/Tables 3

Table 1

Primer sequence of mecA and PVL gene of Staphylococcus aureus

基因	引物序列	退火温度（ $℃$ ）
mecA	F:5’-CTGCTACAGGTATCCGTGAATA-3’ R:5’-TTGTATTGACTGTATCTCTTTGGA-3’	60
PVL	F:5’-TGTGCCAGACAATGAATTACCC-3’ R:5’-AGTAACATCCATATTTCTGCCATACG-3’	57

Table 1

Table 2

Table 3

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临床分布特征	菌株数（n）	构成比（%）
性别
男	83	62.4
女	50	37.6
科室
呼吸与危重症医学科	29	21.8
重症医学科	25	18.8
骨科	17	12.8
烧伤整形科	13	9.8
泌尿外科	9	6.8
其他科室	40	30.1
感染类型
皮肤疖痈、褥疮	63	47.4
上呼吸道感染	31	23.3
下呼吸道感染	18	13.5
尿路感染	7	5.3
血流感染	7	5.3
其他感染	7	5.3
主要基础疾病
高血压	33	24.8
糖尿病	27	20.3
肺部疾病	14	10.2
心脏病	8	6.0

抗菌药物	金黄色葡萄球菌（n=133）		耐甲氧西林金黄色葡萄球菌（n=31）		甲氧西林敏感金黄色葡萄球菌（n=102）
抗菌药物	耐药株数	耐药率（%）	耐药株数	耐药率（%）	耐药株数	耐药率（%）
青霉素	117	88.0	31	100.0	86	84.3
红霉素	46	34.6	18	58.1	28	27.5
克林霉素	40	30.1	16	51.6	24	23.5
苯唑西林	33	24.8	31	100.0	2	2.0
奎奴普丁/达福普汀	25	18.8	8	25.8	17	16.7
四环素	24	18.0	10	32.3	14	13.7
复方磺胺甲恶唑	11	8.3	7	22.6	4	3.9
环丙沙星	8	6.0	5	16.1	3	2.9
莫西沙星	6	4.5	3	9.7	3	2.9
左氧氟沙星	8	6.0	3	9.7	5	4.9
庆大霉素	3	2.3	3	9.7	0	0
替加环素	0	0	0	0	0	0
呋喃妥因	0	0	0	0	0	0
利奈唑胺	0	0	0	0	0	0
万古霉素	0	0	0	0	0	0
利福平	0	0	0	0	0	0