慢性鼻窦炎患者金黄色葡萄球菌耐药分布情况及毒力型分析

Drug resistance and distribution of Staphylococcus aureus in patients with chronic rhinosinusitis

目的探讨慢性鼻窦炎患者金黄色葡萄球菌感染流行及耐药情况,并分析其毒力性基因分布情况。方法选择本院2017年8月-2018年8月诊断为慢性鼻窦炎的患者90例,所有患者均进行鼻腔分泌物培养,分离金黄色葡萄球菌并进行药敏实验,分析菌群的耐药采用PCR法对分离鉴定的金黄色葡萄球菌进行毒力型基因分析。结果耐药组患者鼻部症状、睡眠障碍、情感结局、症状评分均高于非耐药组患者,耐药组患者检出率依次为seb(73.3%)、sea(40.0%)、etb(33.3%)、sed(26.7%),耐药组seb检出率明显高于非耐药组,差异有统计学意义(P<0.05)。金黄色葡萄球菌药敏结果对万古霉素、亚胺培南、头孢西丁的敏感率(敏感+中敏)分别为91.7%、96.7%、66.7%,对链球菌、青霉素、头孢曲松的耐药率分别为50.0%、33.3%、41.7%。结论慢性鼻-鼻窦炎金黄色葡萄球菌感染具有较高的耐药率与其毒力型基因密切相关。

Objective To investigate the prevalence and drug resistance of Staphylococcus aureus infection in patients with chronic sinusitis,and to analyze the distribution of virulence genes.Methods Ninety patients with chronic sinusitis diagnosed in our hospital from September 2017 to September 2018 were selected.All patients were cultured with nasal secretions.Staphylococcus aureus was isolated and tested for drug susceptibility.The virulence genotype of Staphylococcus aureus was analyzed by PCR.Results The nasal symptoms,sleep disorders,emotional outcomes and symptom scores of drug-resistant group were higher than those of non-drug-resistant group.The detection rates of drug-resistant group were seb(73.3%),sea(40.0%),etb(33.3%)and sed(26.7%).The detection rates of seb in drug-resistant group were significantly higher than those in non-drug-resistant group,with the differences statistically significant(P<0.05).The susceptibility rates of Staphylococcus aureus to vancomycin,imipenem and cefoxitin were 91.7%,96.7%and 66.7%.The resistance rates to streptococcus,penicillin and ceftriaxone were 50.0%,33.3%and 41.7%.Conclusion The high drug resistance rate of chronic rhinosinusitis Staphylococcus aureus infection is closely related to its virulence gene.