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重症监护病房患者中心静脉导管分离出的凝固酶阴性葡萄球菌中mecA和qacA/B基因的分布情况。

Distribution of mecA and qacA/B genes among coagulase negative staphylococci isolated from central venous catheters of intensive care unit patients.

作者信息

Medis Sohani, Dissanayake Thushari, Weerasekera Manjula, Namali Dhananja, Gunasekara Samanmalee, Kottahachchi Jananie

机构信息

Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Werehera, Sri Lanka; Faculty of Graduate Studies, University of Sri Jayewardenepura, Sri Lanka.

Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka.

出版信息

Indian J Med Microbiol. 2022 Oct-Dec;40(4):505-509. doi: 10.1016/j.ijmmb.2022.08.006. Epub 2022 Aug 26.

Abstract

PURPOSE

This study was designed to detect the prevalence of antibiotic and antiseptic resistance genes, mecA and qacA/B in coagulase negative Staphylococcus (CoNS) species isolated from intensive care unit patients with catheter related blood stream infections (CRBSI) or colonized central venous catheters (CVC).

METHODS

Consecutive CoNS isolates from ICU patients with CRBSI or colonized central venous catheters were speciated and antibiotic susceptibilities were determined. The mecA and qacA/B genes were detected by polymerase chain reaction.

RESULTS

Eighty-two CoNS isolates from ICU patients with CRBSI (n ​= ​8) or colonized CVC (n ​= ​74) were included. The mecA gene was detected in 62 CoNS isolates (76%). The commonest species isolated was S. haemolyticus (n ​= ​34; 41%) and 30 of these possessed mecA which was significantly higher compared to other CoNS species (p ​= ​0.036). The qacA/B gene was detected in 13 (16%) isolates. Eleven (13%) CoNS had both genes. A significant association was seen with the presence of mecA and resistance to cloxacillin (p ​< ​0.001) and erythromycin (p ​= ​0.046). Presence of qacA/B (p ​= ​0.007) or both mecA and qacA/B (p ​= ​0.014) was associated with a higher resistance to clindamycin.

CONCLUSION

A considerably high prevalence of mecA and qacA/B genes as well as co-existence of both genes is noted among the CoNS isolated from ICU patients. This indicates the need of taking prompt actions in hospital acquired infection prevention including continuous surveillance.

摘要

目的

本研究旨在检测从患有导管相关血流感染(CRBSI)或定植中心静脉导管(CVC)的重症监护病房患者中分离出的凝固酶阴性葡萄球菌(CoNS)物种中抗生素和防腐剂耐药基因mecA和qacA/B的流行情况。

方法

对来自患有CRBSI或定植中心静脉导管的重症监护病房患者的连续CoNS分离株进行菌种鉴定并测定抗生素敏感性。通过聚合酶链反应检测mecA和qacA/B基因。

结果

纳入了82株从患有CRBSI(n = 8)或定植CVC(n = 74)的重症监护病房患者中分离出的CoNS分离株。在62株CoNS分离株(76%)中检测到mecA基因。分离出的最常见菌种是溶血葡萄球菌(n = 34;41%),其中30株携带mecA,与其他CoNS菌种相比显著更高(p = 0.036)。在13株(占16%)分离株中检测到qacA/B基因。11株(占13%)CoNS同时具有这两种基因。观察到mecA的存在与对氯唑西林耐药(p < 0.001)和对红霉素耐药(p = 0.046)之间存在显著关联。qacA/B的存在(p = 0.007)或mecA和qacA/B同时存在(p = 0.014)与对克林霉素的更高耐药性相关。

结论

在从重症监护病房患者中分离出的CoNS中,mecA和qacA/B基因的流行率相当高,并且两种基因同时存在。这表明在医院获得性感染预防中需要立即采取行动,包括持续监测。

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