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目的分析本院2015年携带PVL基因的MRSA分子分型及临床特征,为PVL阳性MRSA的预防及治疗提供实验室依据。方法收集本院2015年MRSA,通过PCR检测PVL基因,用脉冲场凝胶电泳及SCCmec分型对PVL阳性菌株进行分子分型,分析标本类型及临床特征;应用微量肉汤法检测MRSA对13种抗生素的药物敏感性。结果 26株PVL阳性菌株脉冲场凝胶电泳分为11个型别,以E型为主,45岁以下发病人群占65.3%;SCCmec分型以Ⅳa型(42.3%)和Ⅴ型(50.0%)为主;标本类型以分泌物(34.6%)和脓液(23.1%)为主;科室来源以外科门诊(38.5%)和ICU(34.6%)为主;PVL阳性MRSA对青霉素、红霉素、克林霉素、四环素抗生素耐药率较高,18株可确定为社区相关性MRSA。结论本院26株PVL阳性MRSA的SCCmec分型以Ⅳa和Ⅴ型为主,大部分为青壮年,且大都为社区相关性MRSA,治疗可先选取非β-内酰胺类抗生素。
Objective To analyze the molecular typing and clinical features of MRSA carrying PVL gene in 2015 in our hospital and provide laboratory evidence for the prevention and treatment of PVL-positive MRSA. Methods The MRSA of our hospital was collected in 2015. PVL gene was detected by PCR. The PVL positive strains were genotyped by pulsed-field gel electrophoresis and SCCmec typing. The types and clinical features of PVL were analyzed. Antibiotic drug sensitivity. Results The 26 strains of PVL positive strains were divided into 11 types by pulsed-field gel electrophoresis, with type E as the main type and 65.3% of the patients under 45 years of age. The SCCmec types were Ⅳa (42.3%) and Ⅴ (50.0%), (34.6%) and pus (23.1%). The main source of the department was surgical outpatient (38.5%) and ICU (34.6%). PVL-positive MRSA was sensitive to penicillin, erythromycin, Clindamycin, tetracycline antibiotic resistance rate is higher, 18 can be identified as community-related MRSA. Conclusion The SCCmec types of 26 PVL positive MRSA patients in our hospital are mainly Ⅳa and Ⅴ type, most of them are young and middle-aged, and most of them are community-related MRSA. Non-β-lactam antibiotics may be selected first in treatment.