某医院ICU病房金黄色葡萄球菌分子特征及耐药致病性分析

Analysis on Molecular typing and antimicrobial susceptibility of Staphylococcus aureus isolated from intensive careunits

目的探讨分离自兰州军区乌鲁木齐总医院ICU病房金黄色葡萄球菌分子型别特征及耐药情况,为防控金黄色葡萄球菌感染提供依据。方法收集2012年6月至2016年4月ICU病房连续分离的非重复金黄色葡萄球菌98株,应用SCCmec分型,spa分型及多位点序列分型(Multilocus sequence typing,MLST)等方法进行分子分型,检测pvl基因,检测这些菌株万古霉素等临床常用抗生素的药物敏感性,分析金黄色葡萄球菌的耐药和致病情况。结果 98株金黄色葡萄球菌中有63株MR SA,35株为MSSA。MR SA和MSSA中主要流行克隆分别为MR SA-ST239-SCCmec III-t030(93.7%,59/63)及MSSA-ST22-t309(40.0%,14/35);所有菌株pvl基因的阳性率为28.6%(28/98),其中25株为MSSA菌株;主要流行克隆具有特定的耐药谱。结论引起兰州军区乌鲁木齐总医院ICU患者感染主要金黄色葡萄球菌流行克隆为具有较高的耐药性MR SA-ST239-SCCmec III-t030及pvl基因阳性菌株MSSA-ST22-t309,值得临床医师重视。

Objective To investigate the molecular characterization and drug susceptibilities of Staphylococcus aureus isolated from intensive care units at our hospital. Methods A total of 98 Staphylococcus aureus were eonsecutively isolated and collected from intensive care units from February 2012 to April 2016. All isolates were characterized by susceptibility tests and molecular typing, including multilocus sequence typing and pvl gene detection. And MRSA were analyzed through SCCmee typing. Results In the 98 isolates, 63 of them were MRSA isolates, the other 35 cases were MSSA. Among MRSA isolates, ST239-SCCmecIII-t030 clone was the most common elone （93.7%,59/63）. Among the MSSA isolates, ST22-t309 （40.0%,14/35） were the predominant clones. 28.6% isolates also earried pvl genes, most of them were MSSA clone. Furthermore, the major prevailed clones with specific drug resistant profdes were found. Conclusion High resistance clone MRSA-ST239-SCCmeeIII-t030 and pvl positive clone MSSA-ST22-t309 were the most common clones among patients in intensive care units at our hospital.