住院患者与医院环境中耐甲氧西林金黄色葡萄球菌PFGE分子分型研究

PFGE Analysis of Methicillin-resistant Staphylococcus aureus Isolated from Inpatients and Hospital Environment

中文关键词: 耐甲氧西林金黄色葡萄球菌  脉冲场凝胶电泳  基因型  同源性  医院环境

英文关键词: methicillin-resistant Staphylococcus aureus  pulsed-field gel electrophoresis (PFGE)  genotype  homology  hospital environment

中文摘要:

      目的 检测并分析某教学医院住院患者与环境中耐甲氧西林金黄色葡萄球菌(MRSA)携带情况,分析住院患者与环境分离MRSA菌株的同源性.方法 在上海市某教学医院采集住院患者样本418例和医院环境样本204例,分离鉴定MRSA,采用脉冲场凝胶电泳(PFGE)对MRSA进行基因分型,并分析同源性.结果 共分离MRSA43株,其中从患者样本中分离17株,环境样本中分离26株,医院环境中公共用品分离率(23.5％)最高,与医护人员直接接触物品分离率(3.1％)差异有统计学意义.PFGE分型显示43株MRSA可分为23个基因型,其中A型(27.9％)最多,F型(9.3％)和L型(7.0％)其次,其余型别分离1～2株.部分相同或高度相似的PFGE型别的MRSA在不同患者和医院环境中都有检出.结论 该院医院环境中MRSA检出率较高,且与住院患者样本中检出的MRSA呈现一定的同源性,应加强环境消毒和医护人员防控意识,最大限度减少交叉感染的发生.

英文摘要:

      Objective To investigate the carrying situation of methicillin-resistant Staphylococcus aureus (MRSA)in inpatients and in environment of a teaching hospital and to analyze the homology of MRSA isolated from inpatients and from the hospital environment.Methods In total,418 specimens from inpatients and 204 specimens from hospital environment were collected and then cultured and identified for MRSA;pulsed field gel electrophoresis (PFGE) was applied in genotyping and homology analysis.Results Forty-three strains of MRSA were finally isolated:17 from inpatients and 26 from hospital environment,the isolation rate from public goods was the highest (23.5％),statistically different from that from the goods the medical staff used (3.1％);PFGE analysis showed that the 43 strains of MRSA were classified into 23 genotypes,and the most prevalent type was type A (27.9％),followed by type F (9.3％) and type L (7.0％),other types were identified in 1 or 2 strains;strains of MRSA of partial same or high similarity with certain PFGE types were detected from environment and different patients.Conclusions The detection rate of MRSA was high in hospital environment,and the MRSA strains isolated from patients and hospital environment showed certain homology;the environmental disinfection should be strengthened and the medical staff should pay more attention to the prevention and control of MRSA infection to minimize the occurrence of cross infection.