新时期我国医院感染管理工作思考

Thought on nosocomial infection management in new period

  • 摘要: 目的 通过分析金黄色葡萄球菌凝集因子B(clfB)、金黄色葡萄球菌A蛋白(SPA)分型,探讨clfBspa分型与感染类型的关系。方法 收集2013年6月-2014年2月医院门急诊和住院患者非重复分离的167株金黄色葡萄球菌(包括MSSA 78株、MRSA 89株)进行clfB分型和spa分型,分析菌株分型与患者感染类型;药敏试验结果采用WHONET 5.6软件进行统计分析。结果 78株MSSA获得26个clfB型别,最主要型别为190占16.9%,获得35个spa型别,最主要型别为t126占13.0%;89株MRSA获得18个clfB型别,最主要型别为28、922,分别占34.8%和30.0%,获得14个spa型别,最主要型别为t030占82.0%;t030型MRSA通过clfB分型获得9个型别,有2、3、4、9、144、190、245、922型的MSSA在各种感染均有检出。结论 clfB可辅助SPA分型对医院分离菌株进行临床分析,二者互为补充在局部地区金黄色葡萄球菌流行病学监测方面发挥重要作用。

     

    Abstract: OBJECTIVE To investigate the genotypes of Staphylococcus aureus coagulation facor B (clfB) and S.aureus protein A (SPA) and explore thre relationship between the genopyes of clfB and spa and the types of infections. METHODS From Jun 2013 to Feb 2014, a total of 167 strains of non-repetitive S.aureus (including 78 strains of MSSA and 89 strains of MRSA) were isolated from the patients of outpatient emergency department and the hospitalized patients, then the clfB genotyping and spa genotyping were carried out, the strain typing and types of infections were analyzed, and the statistical analysis of the results of drug susceptibility testing was performed with the use of WHONET 5.6 software. RESULTS Totally 26 clfB genotypes were acquired from 78 strains of MSSA, of which 16.9% were the type 190; totally 35 spa genotypes were acquired, of which 13.0% were the t126. Totally 18 clfB genotypes were obtained from 89 strains of MRSA, of which 34.8% were type 28, and 30.0% were type 922; totally 14 spa genotypes were obtained, of which 82.0% were the t030. A total of 9 clfB genotypes were acquired from the type t030 MRSA; the types of 2, 3, 4, 9, 144, 190, 245, and 922 MSSA were detected positive in the patients with infections. CONCLUSION The spa genotyping assisted by the clfB may contribute to the clinical analysis of the isolated strains; the two are complment to each other, which plays an important role in epidemiological surveillance of the S.aureus strains in local areas.

     

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