【摘要】： 金黃色葡萄球菌目前已經(jīng)成為世界范圍內(nèi)引起人類感染性疾病的首要病原菌,可以引起皮膚軟組織感染及致死性疾病,如心內(nèi)膜炎、肺炎、毒素休克綜合征(TSS)等[1]。從此,MRSA逐漸成為全世界醫(yī)院內(nèi)獲得性感染的主要病因。根據(jù)美國疾病控制和預(yù)防中心(CDC)統(tǒng)計,世界每年約有100,000人感染MRSA,并逐漸擴展到社區(qū),引起社區(qū)獲得性感染的流行。MRSA于1961年由Jevons首次發(fā)現(xiàn),1996年起日本、美國、法國、英國等地陸續(xù)出現(xiàn)了對萬古霉素不敏感金葡菌(VISA),而美國在2002年6月于1例糖尿病病人的靜脈導(dǎo)管口的拭子分離出第1株耐萬古霉素金葡萄菌(VRSA)[2]。同時社區(qū)MRSA(community-acquired MRSA,CA-MRSA)不斷出現(xiàn),且呈上升趨勢,因此有學(xué)者將金葡菌與艾滋病,病毒性乙型肝炎一起并列為世界三大感染性疾病。 MRSA幾乎對所有β-內(nèi)酰胺類抗菌藥物耐藥,對其它臨床常用的抗菌藥物,如紅霉素、四環(huán)素也耐藥,近年來由于頭孢菌素的廣泛應(yīng)用,選擇壓力較大,耐藥性也在不斷增加。其有效治療藥物主要為糖肽類抗菌藥物,如萬古霉素和替考拉寧。我國至今尚未發(fā)現(xiàn)VRSA,但已出現(xiàn)對萬古霉素敏感性下降的金黃色葡萄球菌。MRSA一旦對萬古霉素耐藥,臨床可選用藥將非常有限,從而造成治療上的困難。所以,MRSA的耐藥性及流行病學(xué)研究對于正確治療其引起的感染、防止其播散有重要意義。 本實驗收集了我國十七家教學(xué)醫(yī)院,遍及十五個省的大型教學(xué)醫(yī)院302株MRSA進行葡萄球菌染色體盒子分型(SCCmec)、多位點序列分型(MLST)、葡萄球菌A蛋白(Spa)分型,總結(jié)爆發(fā)流行趨勢,為臨床及時控制院內(nèi)感染提供依據(jù)。
[Abstract]:Staphylococcus aureus has become the leading pathogen of human infectious diseases worldwide. It can cause skin and soft tissue infection and fatal diseases, such as endocarditis, pneumonia, toxin shock syndrome (TSS) and so on. Since then, MRSA has gradually become the main cause of hospital acquired infection in the world. According to (CDC), the Center for Disease Control and Prevention in the United States, about 100000 people in the world are infected with MRSA, each year and gradually spread to the community, causing the epidemic of community-acquired infections. MRSA was first discovered by the Jevons in 1961 and was first discovered in Japan, the United States of America and France since 1996. Vancomycin-insensitive staphylococcus aureus (VISA), appeared in England and the first vancomycin-resistant staphylococcus aureus (VRSA) strain was isolated from the swabs of vein catheters of a diabetic patient in the United States in June 2002.The results showed that the first strain of vancomycin-resistant staphylococcus aureus was isolated from the vein of a diabetic patient in June 2002. At the same time, community MRSA (community-acquired MRSA,CA-MRSA) appeared and showed a rising trend, so some scholars have identified Staphylococcus aureus, AIDS and viral hepatitis B as the three major infectious diseases in the world. MRSA is resistant to almost all 尾-lactam antibiotics, and to other antibiotics commonly used in clinic, such as erythromycin and tetracycline. In recent years, due to the wide use of cephalosporins, the selection pressure is greater and the drug resistance is increasing. Its effective drugs are mainly glycopeptide antibiotics, such as vancomycin and teicoplanin. So far, VRSA, has not been found in China, but Staphylococcus aureus with reduced sensitivity to vancomycin has been found. Once MRSA is resistant to vancomycin, its clinical choice will be very limited, resulting in difficulties in the treatment of MRSA. Therefore, the study of drug resistance and epidemiology of MRSA is of great significance for the correct treatment of the infection caused by the disease and the prevention of its spread. In this experiment, we collected 302 strains of MRSA from 17 teaching hospitals in 15 provinces to classify staphylococcal chromosome box type (SCCmec), multiple point sequence typing, (MLST), A protein (Spa) typing, and the results showed that staphylococci A protein (Spa) typing was carried out in 17 teaching hospitals in China and all over 15 provinces. To summarize the epidemic trend in order to provide evidence for clinical control of nosocomial infection in time.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2008
【分類號】：R181.3

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