Huang Lei, Liu Chengcheng, Li Zhanjie, Huang Xu, Zheng Ruiying, Shi Zhixin, Hong Xin, Qin Yufeng, Liu Genyan
Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
Branch of National Clinical Research Center for Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
Infect Drug Resist. 2023 Jun 2;16:3487-3495. doi: 10.2147/IDR.S410330. eCollection 2023.
To investigate the transmission pathway of a MRSA prevalence in a pancreatic surgery ward in a Chinese teaching hospital.
Molecular epidemiology investigations were carried out combined PFGE, MLST, SCC typing and whole-genome sequencing for 20 successive MRSA isolates (2 isolates from the ward environment). Resistance and virulence genes were detected using specific PCR. Bacterial identification and AST were performed using the Vitek 2 Compact System. Clinical data of enrolled cases were retrieved from electronic case records.
From January 2020 to May 2020, successive isolated 20 MRSA strains were clarified to 2 PFGE patterns (A = 19, B = 1) in the ward. Both isolates from environment and patients belonged to sequence type ST5-SCC II- type t311. MRSA-related resistance genes and were found in each clone. All 20 isolates carried and virulence genes, other virulence genes such as and were also found in partial stains. All patients had fever symptom, 27.8% were accompanied by diarrhea, 88.9% had undergone surgery or invasive procedures within 30 days. Finally, 94.4% of these patients recovered.
This study confirmed a prevalence of ST5-MRSA-II-t311 clone in a surgery ward, indicated MRSA is a risk factor for post-surgery nosocomial infection and hand hygiene and environmental surveillance should not be ignored.
调查某中国教学医院胰腺外科病房耐甲氧西林金黄色葡萄球菌（MRSA）的传播途径。
对20株连续分离的MRSA菌株（2株来自病房环境）联合采用脉冲场凝胶电泳（PFGE）、多位点序列分型（MLST）、葡萄球菌盒式染色体（SCC）分型及全基因组测序进行分子流行病学调查。采用特异性聚合酶链反应（PCR）检测耐药和毒力基因。使用Vitek 2 Compact系统进行细菌鉴定和药敏试验。从电子病历中检索纳入病例的临床资料。
2020年1月至2020年5月，该病房连续分离的20株MRSA菌株经PFGE分型明确为2种模式（A = 19，B = 1）。环境和患者分离株均属于序列型ST5-SCC II-型t311。在每个克隆中均发现了与MRSA相关的耐药基因。20株分离株均携带 和 毒力基因，部分菌株还发现了其他毒力基因如 和 。所有患者均有发热症状，27.8%伴有腹泻，88.9%在30天内接受过手术或侵入性操作。最终，94.4%的患者康复。
本研究证实了手术病房中ST5-MRSA-II-t311克隆的流行，表明MRSA是术后医院感染的危险因素，手卫生和环境监测不容忽视。
