德黑兰医科大学附属医院ICU、NICU及外科住院患者耐甲氧西林金黄色葡萄球菌的调查

M. Rahimkhani
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引用次数: 0

摘要

背景与目的:金黄色葡萄球菌是引起多种感染的重要病原菌。这种细菌中一些致病因子的存在有助于细菌在免疫系统和抗菌治疗的反应中存活。近年来,治疗这些菌株引起的感染的努力导致对大多数抗生素产生耐药性,特别是对甲氧西林和万古霉素产生耐药性。因此,由这种细菌引起的感染后果可能很严重。本研究旨在调查德黑兰医科大学医院ICU、NICU和外科住院患者中分离的耐甲氧西林金黄色葡萄球菌。材料与方法:收集430例患者临床标本,经表型和生物型试验鉴定为金黄色葡萄球菌。首先通过圆盘扩散法筛选对头孢西丁耐药的MRSA分离株,最后通过PCR检测mecA基因进行鉴定。采用纸片扩散法测定了MRSA的微生物耐药模式。用PCR方法对分离的MRSA中万古霉素耐药基因的存在进行了调查。结果:430份临床标本中分离金黄色葡萄球菌117例(27.20%),其中MRSA 42例(35.89%)。重症监护室感染MRSA最多,25例(59.52%)。MRSA感染患者以40 ~ 65岁年龄组居多。所有MRSA均检测到mecA基因。整个MRSA对万古霉素和利奈唑胺100%敏感,对氯西林100%耐药。对分离的MRSA进行vanA基因分子检测,其中2例(4.76%)含有vanA基因。结论:MRSA的高流行率及其对万古霉素和其他抗生素家族的耐药模式可导致治疗失败、院内感染失控和死亡。尽管基于pcr的检测方法优于其他传统技术,但这些方法的组合可以提供诊断准确性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Survey of Methicillin-Resistance Staphylococcus aureus Isolated from Patients Hospitalized in the ICU, NICU and Surgical Departments of Tehran University of Medical Sciences Hospitals
Background and Aim: Staphylococcus aureus is an important pathogen that causes various infections. The presence of some pathogenic factors in this bacterium helps the bacteria to survive in response to the immune system and antimicrobial treatments. Efforts to treat infections caused by these strains have resulted in resistance to most antibiotics, especially methicillin and vancomycin resistance, during recent years. Therefore, the consequences of infections caused by this bacterium can be serious. In this study we aimed to survey methicillin- resistance Staphylococcus aureus isolated from patients hospitalized in the ICU, NICU and surgical departments of Tehran University of Medical Sciences hospitals. Material and Method: 430 clinical samples of the patients were collected and identified as Staphylococcus aureus by phenotype and biotype tests. MRSA isolates were first screened by showing resistance to cefoxitin by disc diffusion method and finally confirmed by examining the mecA gene by PCR. The microbial resistance pattern of MRSA was also measured by disk diffusion method. Investigating the presence of a vancomycin resistance gene in isolated MRSA occurred by PCR. Results: Out of 430 clinical samples, 117 (27.20%) Staphylococcus aureus were isolated of which 42 (35.89%) were identified as MRSA. The most MRSA obtained from the ICU department with 25 cases (59.52%). The majority of patients infected with MRSA belonged to the age group of 40-65 years. The mecA gene was detected in all MRSA. The entire MRSA was 100% sensitive to vancomycin and linezolid, and 100% resistance to cloxacillin. Molecular detection of vanA gene in isolated MRSA showed 2 (4.76%) of them contained vanA gene. Conclusion: The high prevalence of MRSA and its antibiotic resistance pattern to vancomycin and other antibiotic families can lead to treatment failures, uncontrolled nosocomial infections, and mortality. Although the PCR-based detection method is superior to other conventional techniques, a combination of these methods can provide diagnostic accuracy.
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