MRSA呼吸系统医院感染的分子流行病学调查

Meticillin-resistant Staphylococcus aureus in A Respiratory Disease Institute:An Epidemiologic Survey by PFGE

目的 对广州呼吸疾病研究所 2 0 0 1年 7月～ 2 0 0 3年 3月间 ,金黄色葡萄球菌引起的呼吸系统医院感染进行病原学监测。方法 收集临床分离菌株 ,应用脉冲场凝胶电泳的方法 (PFGE)进行分型 ,确定菌株亲缘关系 ,结合临床资料分析。结果 在各种呼吸道采集标本中共收集到 76株金黄色葡萄球菌 ,耐甲氧西林金黄色葡萄球菌(MRSA) 6 8株 ,占金黄色葡萄球菌检出率 89.4 7%,MRSA在我所病区中引起 5 9例医院感染 ,属于暴发形式发病的有 2 3例 ,属于聚集性发病的有 19例 ,散发病例 17例 ,PFGE分型表明 ,绝大多数MRSA属于同一型 (A型 )共有 6 0株 ,其中A1亚型 2 8株 ,A2亚型 14株 ,A3亚型 17株 ,A4亚型 1株。结论 MRSA引起的呼吸系统医院感染十分严重 ,并主要由少数菌株的传播引起 ,及时采取有效措施控制MRSA的流行和播散非常必要。

OBJECTIVE To investigate the outbreak of MRSA in respiratory ward. METHODS Seventy-six Staphylococcus aureus strains isolated in the respiratory ward of Guangzhou Medical College Hospital between Jul 2001 and Mar 2003 were studied. All the MRSA were identified by using commonly phenotypic procedure combined with MRSA screen latex test and on all isolates susceptibility tests were performed. Genotypes of the isolates were investigated by pulsed-field gel electrophoresis (PFGE). RESULTS There were 68 MRSA isolates among 76 S. aureus isolates (89.47%). Fifty nine strains of them were nosocomial infection pathogens. Outbreaks were registered to 23 cases and cluster 19, while single events remained 28.81% of all MRSA infections. The PFGE patterns of 68 MRSA isolates were classified into 10 types and subtypes, from them: type A (a total of 60 isolates) and its subtypes A1(28) and A2(14), A3(17), A4(1) were predominant. CONCLUSIONS The respiratory nosocomial infection caused by MRSA is serious. It is necessary to take effective measures to control the MRSA prevalence.