Yang Xueying, Zhao Jing, Wang Yong, Wu Jian, Wang Xiaohong, Wang Yuchao, Zhang Yiru, Li Huiling
Department of Microbiology, The First Affiliated Hospital of Jiamusi University, Jiamusi, 154002, Heilongjiang, People's Republic of China.
Department of Biochemistry, Jiamusi Maternal and Child Health Hospital, Jiamusi, 154002, Heilongjiang, People's Republic of China.
Infect Drug Resist. 2021 Apr 28;14:1635-1643. doi: 10.2147/IDR.S307856. eCollection 2021.
Recently, owing to antibiotic resistance, the incidence of methicillin-resistant (MRSA) colonization among intensive care unit (ICU) patients has increased rapidly. So far, there are few studies on active screening of MRSA. The purpose of the current study was to verify the effectiveness of active screening and analyze the molecular epidemiological characteristics of MRSA in the region.
We collected 30 samples of the MRSA strains from a tertiary hospital in the Eastern Heilongjiang Province. Among them, 7 were retrieved through nasal vestibular swabs at the emergency ICU and 23 were obtained from clinical specimens. Additionally, relevant patient medical information was examined retrospectively and molecular epidemiology and risk factor analysis for MRSA were performed.
Molecular epidemiology studies revealed that all strains of bacteria carried the mecA resistance gene. The Panton Valentine leukocidin (PVL), for instance, was detected at a rate of 13.33% (4/30). The protein A (spa) types, found amongst our samples, were mainly t324, t437, t034, etc., and we discovered a new spa type t19702. We also revealed 3 types of SCCmec, namely, SCCmec type II, SCCmec type IVa, and SCCmec type V, with the most prevalent clonotypes being ST72 and ST59. In addition, we also found 7 new ST types, namely, ST6567, ST6568, ST6569, ST6570, ST6571, ST6572, and ST6573. Using risk factor analysis, we also demonstrated that long, invasive procedures used in the ICU, such as tracheal intubation and ventilator usage, along with patients with cerebral infarction and other embolism are more susceptible to developing MRSA colonization and further infections.
We recommend the infection control department within hospitals to actively screen for MRSA and perform risk factor analysis in order to establish accurate preventive measures for controlling MRSA spread.
近年来，由于抗生素耐药性问题，重症监护病房（ICU）患者中耐甲氧西林金黄色葡萄球菌（MRSA）定植的发生率迅速上升。到目前为止，关于MRSA主动筛查的研究较少。本研究的目的是验证主动筛查的有效性，并分析该地区MRSA的分子流行病学特征。
我们从黑龙江省东部的一家三级医院收集了30株MRSA菌株样本。其中，7株通过急诊ICU的鼻前庭拭子获取，23株从临床标本中获得。此外，回顾性检查了相关患者的医疗信息，并对MRSA进行了分子流行病学和危险因素分析。
分子流行病学研究表明，所有菌株均携带mecA耐药基因。例如，杀白细胞素（PVL）的检出率为13.33%（4/30）。在我们的样本中发现的蛋白A（spa）类型主要为t324、t437、t034等，并且我们发现了一种新的spa类型t19702。我们还发现了3种葡萄球菌盒式染色体mec（SCCmec）类型，即II型、IVa型和V型，最常见的克隆型为ST72和ST59。此外，我们还发现了7种新的序列类型（ST），即ST6567、ST6568、ST6569、ST6570、ST6571、ST6572和ST6573。通过危险因素分析，我们还证明，ICU中使用的长时间侵入性操作，如气管插管和使用呼吸机，以及患有脑梗死和其他栓塞的患者更容易发生MRSA定植和进一步感染。
我们建议医院感染控制部门积极筛查MRSA并进行危险因素分析，以便建立准确的预防措施来控制MRSA传播。
