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目的对耐甲氧西林金黄色葡萄球菌(MRSA)菌株进行分子分型,探讨ICU中MRSA医院感染的特点和流行规律。方法采用表型筛选和PCR扩增mecA基因方法鉴定MRSA菌株,脉冲场凝胶电泳方法(PFGE)进行分子分型。结果12株金黄色葡萄球菌表型筛选为MRSA,MRSA产生A型、B型、C型和D型4种耐药表型,优势耐药模式是A型(75.0%),MRSA对苯唑西林、阿莫西林/克拉维酸和氨苄西林/舒巴坦等10种抗生素产生100%耐药性,11株MRSA携带mecA基因,携带率为91.7%,PFGE指纹图谱分两型,分别为R1型和R2型,11株MRSA为R1型(91.7%),R1型各株间相似度为100%。结论ICU可存在MRSA爆发流行,MRSA产生多重耐药性(MDR),MRSA携带mecA基因可表现为MDR,PFGE分型是理想的分子流行病学溯源手段。
OBJECTIVE: To characterize and popularize MRSA nosocomial infection in ICU by molecular typing of methicillin-resistant Staphylococcus aureus (MRSA) strains. Methods MRSA strains were identified by phenotyping and PCR amplification of mecA gene, and molecular typing was performed by pulsed-field gel electrophoresis (PFGE). Results The 12 Staphylococcus aureus phenotypes were screened as MRSA. MRSA produced four kinds of drug resistance phenotypes (A, B, C and D). The dominant drug resistance pattern was type A (75.0%), MRSA was sensitive to oxacillin , 10 kinds of antibiotics such as amoxicillin / clavulanic acid and ampicillin / sulbactam produced 100% drug resistance, 11 strains of MRSA carried mecA gene, carrying rate was 91.7%, PFGE fingerprinting was divided into two types, namely R1 type And R2, the eleven strains of MRSA were type R1 (91.7%), and the similarity between type R1 strains was 100%. Conclusions The prevalence of MRSA outbreaks in ICU and multidrug resistance (MRR) in MRSA can be found in ICU. The mecA gene in MRSA can be expressed as MDR. PFGE typing is an ideal molecular epidemiological tracing method.