發(fā)布時間：2018-04-30 01:12

  本文選題：耐甲氧西林金黃色葡萄球菌 + 流行病學��； 參考：《中華醫(yī)院感染學雜志》2017年23期

【摘要】：目的研究老年患者耐甲氧西林金黃色葡萄球菌(MRSA)的流行病學及多位點序列分型。方法隨機選取醫(yī)院檢驗科2016年5月-2017年5月間收集老年患者臨床樣本分離MRSA菌株30株,分別進行藥敏鑒定試驗,建立多位點序列分型(MLST)方法并檢測染色體7個管家基因,測序結果與MLST數(shù)據(jù)庫網(wǎng)站已有序列比對,進行聚類分析,統(tǒng)計克隆系及ST菌株親緣關系發(fā)育樹,并分析MLST耐藥性影響因素。結果 MRSA菌株分2大集群A和B,A群由USA100和USA800型組成,B群由USA300和USA700型菌株組成;所有分離菌株均為耐苯唑西林、阿莫西林/克拉維酸菌株;10株耐藥菌對萬古霉素的最低抑菌濃度(MIC)1μg/mL;Logistic回歸分析結果顯示,PVL陽性與萬古霉素MIC增加存在顯著相關性(P0.05)。結論本研究數(shù)據(jù)表明老年患者MRSA分離株均為耐苯唑西林、阿莫西林/克拉維酸菌,針對老年患者臨床用藥時,需考慮相關影響因素進行防控。
[Abstract]:Objective to study the epidemiology and multi-locus sequence typing of MRSAs resistant to methicillin-resistant Staphylococcus aureus in elderly patients. Methods from May 2016 to May 2017, 30 strains of MRSA strains were randomly selected from clinical samples of elderly patients in our hospital. The drug sensitivity test was carried out, and the multilocus sequence typing method was established and 7 housekeeping genes were detected. Sequencing results were compared with MLST database site, cluster analysis was carried out, clone lines and ST-strain phylogenetic tree were analyzed, and the influencing factors of MLST resistance were analyzed. Results MRSA strains were divided into two groups: group A and B were composed of USA100 and USA800, group B was composed of USA300 and USA700, and all isolates were oxacillin resistant. The minimum inhibitory concentration of amoxicillin / clavulanic acid resistant strains to vancomycin was 1 渭 g / mL logistic regression analysis showed that there was a significant correlation between the positive concentration of amoxicillin / clavulanic acid and the increase of vancomycin MIC. Conclusion the data of this study indicate that the isolates of MRSA in elderly patients are oxacillin resistant, amoxicillin / clavulanic acid bacteria, and the related factors should be considered to prevent and control the clinical use of Amoxicillin / clavulanic acid in elderly patients.
【作者單位】： 齊齊哈爾醫(yī)學院附屬第二醫(yī)院檢驗科;
【基金】：黑龍江省教育廳基金資助項目(12531807)
【分類號】：R446.5;R515
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本文編號：1822396