新生儿携带MRSA和MSSA的现状及其耐药谱分析

王莹莹; 周鑫; 吴传安; 郑惠结; 郑浩渠; 姚振江

doi:10.16462/j.cnki.zhjbkz.2019.10.027

新生儿携带MRSA和MSSA的现状及其耐药谱分析

doi: 10.16462/j.cnki.zhjbkz.2019.10.027

1.
510310 广州, 广东药科大学公共卫生学院流行病与卫生统计学教研室
2.
518109 深圳, 深圳市龙华新区妇幼保健中心信息科

基金项目:

广东省科技计划项目 2014A020213013

广东药科大学“创新强校工程”资助项目 2016

详细信息

通讯作者:
姚振江, E-mail: zhjyao2001@yahoo.com

中图分类号: R722.13;R174.1
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出版历程
- 收稿日期: 2019-04-01
- 修回日期: 2019-07-10
- 刊出日期: 2019-10-10

Carriage prevalence and drug resistance profile of MRSA and MSSA strains isolated from newborns

1.
Faculty of Epidemiology and Health Statistics, School of public health, Guangdong pharmaceutical university, Guangzhou 510310, China
2.
Department of Information, Shenzhen Longhua New District Maternal and Child Health Center, Shenzhen 518109, China

Funds:

Science and Technology Plan Project of Guangdong Provence 2014A020213013

Innovation and Strong School Project of Guangdong Pharmaceutical University 2016

More Information

Corresponding author: YAO Zhen-jiang, E-mail: zhjyao2001@yahoo.com

摘要

摘要: 目的了解新生儿耐甲氧西林金黄色葡萄球菌（methicillin-resistant staphylococcus aureus，MRSA）和甲氧西林敏感金黄色葡萄球菌（methicillin-sensitive staphylococcus aureus，MSSA）的携带现状及其耐药情况。方法采用横断面研究，于2015年8月-11月，对深圳市龙华区人民医院和观澜医院的1 834名新生儿进行棉拭子采样、菌株分离鉴定及药物敏感试验。结果新生儿金黄色葡萄球菌（staphylococcus aureus，SA）、MRSA、MSSA的携带率分别为3.27%（60/1 834）、0.82%（15/1 834）、2.45%（45/1 834）。MRSA与MSSA对青霉素、红霉素的耐药率较高，对利奈唑胺的耐药率均小于10%。MRSA对红霉素、莫西沙星、克林霉素的耐药率均高于MSSA（均有P < 0.05）；MRSA的多重耐药率高达80.00%，风险是MSSA的12.36倍。结论该地区新生儿SA尤其是MRSA多重耐药率较高，且MRSA耐药情况比MSSA更严重。
- 新生儿 /
- MRSA /
- MSSA /
- 携带现状 /
- 耐药谱
Abstract: Objective To determine the carriage prevalence and antibiotics resistance profile of methicillin-resistant staphylococcus aureus(MRSA) and methicillin-sensitive staphylococcus aureus(MSSA) strains isolated from newborns. Methods A cross-sectional study was conducted in two hospitals in Shenzhen from August to November 2015. Cotton swab samples were collected from 1834 newborns. Staphylococcus aureus was identified by general laboratory tests, and antimicrobial-susceptibility profiles was tested. Results In total, 3.27% (60/1 834) Staphylococcus aureus (SA) strains were isolated, including 0.82% (15/1 834) MRSA and 2.45% (45/1 834) MSSA. Most MRSA and MSSA strains were resistant to penicillin and erythromycin but less than 10% strains resistant to linezolid. Drugs resistance rates of MRSA to erythromycin, moxifloxacin and clindamycin were all higher than that of MSSA (all P < 0.05). The multidrug-resistant risk of MRSA (80.00%) was 12.36 times higher than that of MSSA (24.44%). Conclusions Multidrug-resistant SA especially MRSA strains isolated from newborns had the higher prevalence, the drugs resistance rate of MRSA strains was more serious than that of MSSA.
- Newborns /
- MRSA /
- MSSA /
- Carriage prevalence /
- Antibiotics resistance profile

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图 1 60名新生儿携带MRSA和MSSA耐药种类的分布

注：^a表示MRSA和MSSA耐药种类的差异有统计学意义(P=0.012)。

Figure 1. Distribution of drug-resistant species in MRSA and MSSA isolated from 60 newborns

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表 1 60名新生儿携带MRSA和MSSA的耐药情况

Table 1. Drugs resistance rates of MRSA and MSSA isolated from 60 newborns

抗生素	MRSA		MSSA		合计		χ²值	P^a值	OR值(95% CI)
抗生素	n(例)	%	n(例)	%	n(例)	%	χ²值	P^a值	OR值(95% CI)
克林霉素	10	66.67	7	15.56	17	28.33	-	< 0.001	10.86(2.38~52.00)
红霉素	13	86.67	15	33.33	28	46.67	12.86	< 0.001	13.00(2.36~127.50)
庆大霉素	2	13.33	3	6.67	5	8.33	-	0.591	2.15(0.16~20.72)
莫西沙星	3	20.00	0	0.00	3	5.00	-	0.013	13.07(1.34~∞)
利奈唑胺	1	6.67	1	2.22	2	3.33	-	0.441	3.14(0.04~252.17)
利福平	3	20.00	2	4.44	5	8.33	-	0.094	5.38(0.53~68.7)
妥布霉素	2	13.33	9	20.00	11	18.33	-	0.714	0.62(0.06~3.61)
替考拉宁	4	26.67	8	17.78	12	20.00	-	0.472	1.68(0.31~7.81)
头孢西丁	12	80.00	0	0.00	12	20.00	-	< 0.001	177.23(23.62~∞)
青霉素	13	86.67	43	95.56	56	93.33	-	0.258	0.30(0.02~4.66)
复方新诺明	4	26.67	4	8.89	8	13.33	-	0.098	3.73(0.58~23.01)
MDR	12	80.00	11	24.44	23	38.33	14.69	< 0.001	12.36(2.56~76.77)
注：^a表示采用Fisher确切概率法; MDR：多重耐药。

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