本文選題：金黃色葡萄球菌　切入點(diǎn)：耐藥性　出處：《廣東藥學(xué)院》2015年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的探討珠三角地區(qū)職業(yè)性豬接觸與人群攜帶金葡菌的流行水平,攜帶的影響因素,耐藥情況以及分子分型特征,并進(jìn)一步了解人群攜帶動(dòng)物源性金葡菌的現(xiàn)狀,為更好地為制定預(yù)防控制金葡菌的策略和措施提供科學(xué)依據(jù)。方法采用方便抽樣的方法對(duì)深圳、東莞、江門(mén)和佛山4個(gè)地區(qū)的591名職業(yè)人群及843名對(duì)照人群進(jìn)行問(wèn)卷調(diào)查及鼻拭子樣本收集,結(jié)合傳統(tǒng)生化實(shí)驗(yàn)及PCR方法對(duì)收集的樣本進(jìn)行金葡菌的分離鑒定,采用Kirby-Bauer(K-B)紙片擴(kuò)散法對(duì)分離的金葡菌進(jìn)行抗生素敏感性檢測(cè)。應(yīng)用普通PCR方法檢測(cè)pvl毒力基因;采用多重PCR方法對(duì)MRSA進(jìn)行SCCmec分型;應(yīng)用多位點(diǎn)序列分型對(duì)金葡菌進(jìn)行分子分型分析。采用χ2檢驗(yàn)及Fisher確切概率法和非條件的Logistic回歸分析方法分析研究對(duì)象攜帶金葡菌及MRSA的影響因素。結(jié)果591名職業(yè)人群共分離出80株金葡菌(13.5%),MRSA 43株(7.5%);843名對(duì)照人群共分離出97株金葡菌(11.5%),MRSA 16株(1.9%);職業(yè)人群MRSA的攜帶率明顯高于對(duì)照人群(P0.05)。耐藥性分析發(fā)現(xiàn)MRSA對(duì)12種常用抗生素的耐藥性明顯高于MSSA(P0.05),并且發(fā)現(xiàn)職業(yè)人群攜帶的金葡菌對(duì)抗生素的耐藥性和多重耐藥率明顯高于對(duì)照人群。本次分離的177株金葡菌共檢測(cè)出3株攜帶PVL毒素,攜帶率(1.7%)較低,但均來(lái)自職業(yè)人群。SCCmec分型發(fā)現(xiàn)此次分離的MRSA主要為IV型和V型;而MLST分型共發(fā)現(xiàn)了30種ST型別,并在職業(yè)人群中檢出了16株ST9型亞洲流行的動(dòng)物源性金葡菌。影響因素分析發(fā)現(xiàn)30歲年齡組攜帶MRSA的風(fēng)險(xiǎn)是45年齡組的2.75倍,30-45歲年齡組攜帶MRSA的風(fēng)險(xiǎn)是45年齡組的2.56倍。結(jié)論1.職業(yè)人群MRSA的攜帶率明顯高于對(duì)照人群。2.職業(yè)人群攜帶的金葡菌耐藥程度和多重耐藥率明顯高于對(duì)照人群。3.本研究分離的金葡菌PVL毒素的攜帶率較低,但均來(lái)自職業(yè)人群。4.職業(yè)人群中攜帶了亞洲流行的動(dòng)物源性金葡菌。5.本研究對(duì)象攜帶MRSA的影響因素主要與年齡相關(guān)。6.職業(yè)人群與對(duì)照人群攜帶的金葡菌親緣關(guān)系較遠(yuǎn)。
[Abstract]:Objective to investigate the prevalence level of Staphylococcus aureus carrying in occupational pigs and population in Pearl River Delta region, the influencing factors of carrying Staphylococcus aureus, drug resistance and molecular typing characteristics, and to further understand the current situation of carrying Staphylococcus aureus from animals in the population. In order to provide a scientific basis for formulating strategies and measures for the prevention and control of Staphylococcus aureus. 591 professional population and 843 control group in Jiangmen and Foshan were investigated by questionnaire and collected nasal swabs. Staphylococcus aureus was isolated and identified by traditional biochemical experiment and PCR method. The susceptibility of isolated Staphylococcus aureus to antibiotics was detected by Kirby-Baueren K-B-based disk diffusion method, pvl virulence gene was detected by ordinary PCR method, and SCCmec typing of MRSA was performed by multiple PCR method. The molecular typing of Staphylococcus aureus was analyzed by multilocus sequence typing. The influencing factors of staphylococcus aureus and MRSA were analyzed by 蠂 2 test, Fisher exact probability method and non-conditional Logistic regression analysis. A total of 80 strains of Staphylococcus aureus were isolated from the industrial population. A total of 97 strains of Staphylococcus aureus MRSA43 strains were isolated from 843 control subjects, and the carrying rate of MRSA in the occupational population was significantly higher than that in the control group (P0.055.The drug resistance analysis showed that MRSA was resistant to 12 common antibiotics). The drug resistance and multidrug resistance of Staphylococcus aureus carried by professional population were significantly higher than those of control group. Three strains of Staphylococcus aureus were detected to carry PVL toxin. The carrying rate was low, but all of them were from the occupational population. SCCmec typing found that the MRSA isolates were mainly type IV and V type, and 30 St types were found in MLST typing. The risk of carrying MRSA in 30 years old group was 2.75 times higher than that in 45 years old group, and the risk of carrying MRSA in 30-45 years old group was 45 years old, and the risk of carrying MRSA in 30 to 45 years old group was 2.75 times higher than that in 45 years old group, and 16 strains of animal origin staphylococcus aureus were detected in occupational population. Conclusion 1.The carrying rate of MRSA in occupational population was significantly higher than that in control group. The drug resistance and multidrug resistance rate of Staphylococcus aureus in occupational population was significantly higher than that in control group .3.The carrying rate of PVL toxin of Staphylococcus aureus isolated in this study was lower than that in control group. However, all of them were from occupational population. 4. In the occupational population, the prevalence of MRSA in Asia was found. 5. The influencing factors of carrying MRSA were mainly related to age. 6. The relationship between occupational population and control group was far from that of Staphylococcus aureus.
【學(xué)位授予單位】：廣東藥學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R446.5

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本文編號(hào)：1648550