2018—2021年上海某医院环境及患者金黄色葡萄球菌肠毒素基因携带状况

Enterotoxin gene profiles of Staphylococcus aureus isolated from environment and patients in a hospital in Shanghai from 2018 to 2021

【目的】了解上海市嘉定区某医院环境中金黄色葡萄球菌(Staphylococcus aureus)的污染状况,研究医院环境和患者中SAU肠毒素基因携带情况及差异。【方法】采集某医院2018—2021年环境样品进行SAU分离鉴定,收集医院患者中分离的SAU,并对菌株SEA~SEE肠毒素基因进行检测。【结果】780件医院环境样品中54件样品检出金黄色葡萄球菌,阳性率为6.92%。医院环境中病区扶手、患者的枕头被褥和床头柜是阳性率较高的部位,分别为20.00%、20.00%和16.67%。医务人员的环境中鼠标键盘和工作服阳性率较高,分别为17.42%和16.67%。2018—2021年收集患者菌株75株,其中重症监护室(ICU)、神经外科、骨科患者菌株分别占36.00%、14.67%、14.67%。环境与患者的SAU中肠毒素基因携带率分别为48.15%和61.33%,患者SAU中,SEA、SEB、SEC、SED和SEE肠毒素基因携带率依次为14.67%、41.33%、9.33%、1.33%、1.33%,而环境依次为20.37%、25.93%、1.85%、1.85%和0%。环境中综合ICU肠毒素基因携带率为77.27%。患者源的菌株中,痰液菌株数量最多,呼吸内科、ICU、骨科的SAU肠毒素携带率较高。【结论】某医院环境中SAU检出率处于中等水平。SAU肠毒素基因携带率较高,以SEB基因为主,其次为SEA。需加强院内特别是ICU中金黄色葡萄球的消毒与控制。

[Objective]To investigate the prevalence of Staphylococcus aureus in a hospital in Jiading District,Shanghai,and to determine the enterotoxin gene profiles of Staphylococcus aureus isolated from patients and environment.[Methods]Specimens were collected from environment and patients from a hospital for Staphylococcus aureus isolation and identification.Furthermore,enterotoxin genes(SEA‒SEE)of Staphylococcus aureus were detected.[Results]A total of 54 Staphylococcus aureus strains were isolated from 780 hospital environmental specimens from 2018 to 2021,with a prevalence of 6.92%.In the armrests in the wards,patient’s pillows/quilts,and bedside cupboards,the prevalence was determined to be 20.00%,20.00%and 16.67%,respectively.In contrast,in the computer’s mouse and keyboard and work clothes of physicians and nurses,the prevalence was 17.42%and 16.67%,respectively.Meanwhile,from 2018 to 2021,a total of 75 strains were collected from patients,of which 36.00%,14.67%and 14.67%were from the departments of intensive care medicine(ICU),neurosurgery and orthopedics,respectively.The prevalence of Staphylococcus aureus enterotoxin genes were 48.15%and 61.33%in the environment and patients,respectively.Furthermore,the prevalence of SEA,SEB,SEC,SED,and SEE genes were 14.67%,41.33%,9.33%,1.33%,1.33%in patients,respectively,whereas 20.37%,25.93%,1.85%,1.85%and 0%in environmental specimens,respectively.In the environmental specimens isolated from comprehensive ICU,the prevalence of enterotoxin genes was 77.27%.In the patient's specimens,Staphylococcus aureus was mostly isolated in sputum.Additionally,the prevalence of enterotoxin genes was high in the patients of departments of respiratory medicine,ICU,and orthopedics.[Conclusion]Prevalence of Staphylococcus aureus remains moderate in the hospital environment.Enterotoxin genes of Staphylococcus aureus are common,with seb gene as the most common gene,followed by SEA gene.It warrants strengthening the disinfection and control of Staphylococcus aureus in the hospital,especially in the ICU.