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目的 研究老年患者耐甲氧西林金黄色葡萄球菌(MRSA)的流行病学及多位点序列分型。方法 随机选取医院检验科2016年5月-2017年5月间收集老年患者临床样本分离MRSA菌株30株,分别进行药敏鉴定试验,建立多位点序列分型(MLST)方法并检测染色体7个管家基因,测序结果与MLST数据库网站已有序列比对,进行聚类分析,统计克隆系及ST菌株亲缘关系发育树,并分析MLST耐药性影响因素。结果 MRSA菌株分2大集群A和B,A群由USA100和USA800型组成,B群由USA300和USA700型菌株组成;所有分离菌株均为耐苯唑西林、阿莫西林/克拉维酸菌株;10株耐药菌对万古霉素的最低抑菌浓度(MIC)>1μg/m L;Logistic回归分析结果显示,PVL阳性与万古霉素MIC增加存在显著相关性(P<0.05)。结论 本研究数据表明老年患者MRSA分离株均为耐苯唑西林、阿莫西林/克拉维酸菌,针对老年患者临床用药时,需考虑相关影响因素进行防控。
Objective To study the epidemiology and multi-site sequence typing of methicillin-resistant Staphylococcus aureus (MRSA) in elderly patients. Methods A total of 30 clinical isolates of MRSA were collected from May 2016 to May 2017 in our hospital, and 30 strains of MRSA were isolated from the clinical samples. Drug susceptibility tests were carried out respectively to establish a multi-site sequence typing (MLST) Housekeeping genes and sequencing results were compared with those existing on the website of MLST database. Clustering analysis was performed to analyze the phylogenetic tree between clonal strains and ST strains. The influencing factors of MLST resistance were analyzed. Results The MRSA strains were divided into two groups A and B, the group A consisted of USA100 and USA800 and the group B consisted of USA300 and USA700 strains. All isolates were resistant to oxacillin and amoxicillin / clavulanate. 10 The minimum inhibitory concentration (MIC) of strains resistant to vancomycin> 1μg / m L; Logistic regression analysis showed that there was a significant correlation between PVL positive and vancomycin MIC (P <0.05). Conclusion The data of this study indicate that the MRSA isolates of elder patients are resistant to oxacillin and amoxicillin / clavulanic acid bacteria. In clinical treatment of elderly patients, the relevant factors need to be considered for prevention and control.