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1 001名HIV感染者鼻腔MRCoNS与MSCoNS耐药谱比较

何穗平,  叶家萍,  白婵,  李凌华,  李丽雅,  蔡卫平,  王莹莹,  李荧,  张文萃,  刘宁,  贡梓军,  姚振江

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文章导航 > 中华疾病控制杂志  > 2019 >  23(12): 1527-1530
何穗平, 叶家萍, 白婵, 李凌华, 李丽雅, 蔡卫平, 王莹莹, 李荧, 张文萃, 刘宁, 贡梓军, 姚振江. 1 001名HIV感染者鼻腔MRCoNS与MSCoNS耐药谱比较[J]. 中华疾病控制杂志, 2019, 23(12): 1527-1530. doi: 10.16462/j.cnki.zhjbkz.2019.12.018
引用本文: 何穗平, 叶家萍, 白婵, 李凌华, 李丽雅, 蔡卫平, 王莹莹, 李荧, 张文萃, 刘宁, 贡梓军, 姚振江. 1 001名HIV感染者鼻腔MRCoNS与MSCoNS耐药谱比较[J]. 中华疾病控制杂志, 2019, 23(12): 1527-1530. doi: 10.16462/j.cnki.zhjbkz.2019.12.018
shu
HE Sui-ping, YE Jia-ping, BAI Chan, LI Ling-hua, LI Li-ya, CAI Wei-ping, WANG Ying-ying, LI Ying, ZHANG Wen-cui, LIU Ning, GONG Zi-jun, YAO Zhen-jiang. Comparison of antibiotic resistance spectrum between methicillin-resistant and methicillin-susceptible coagulase-negative staphylococci nasal isolates among 1 001 HIV infectors[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2019, 23(12): 1527-1530. doi: 10.16462/j.cnki.zhjbkz.2019.12.018
Citation: HE Sui-ping, YE Jia-ping, BAI Chan, LI Ling-hua, LI Li-ya, CAI Wei-ping, WANG Ying-ying, LI Ying, ZHANG Wen-cui, LIU Ning, GONG Zi-jun, YAO Zhen-jiang. Comparison of antibiotic resistance spectrum between methicillin-resistant and methicillin-susceptible coagulase-negative staphylococci nasal isolates among 1 001 HIV infectors[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2019, 23(12): 1527-1530. doi: 10.16462/j.cnki.zhjbkz.2019.12.018
shu

1 001名HIV感染者鼻腔MRCoNS与MSCoNS耐药谱比较

doi: 10.16462/j.cnki.zhjbkz.2019.12.018
  • 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系

  • 2.

    510060 广州, 广州市第八人民医院感染科

基金项目: 

广东省科技计划项目 2014A020213013

详细信息
    通讯作者:

    姚振江, E-mail: zhjyao2001@yahoo.com

  • 中图分类号: R378.1

Comparison of antibiotic resistance spectrum between methicillin-resistant and methicillin-susceptible coagulase-negative staphylococci nasal isolates among 1 001 HIV infectors

  • 1.

    Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510310, China

  • 2.

    Department of Infectious Diseases, Guangzhou No.8 People's Hospital, Guangzhou 510060, China

Funds: 

Guangdong Science and Technology Plan Project 2014A020213013

More Information

    摘要
  • 摘要:   目的  探究广州市人类免疫缺陷病毒（human immunodeficiency virus，HIV）感染者鼻腔凝固酶阴性葡萄球菌（coagulase-negative staphylococci，CoNS）携带情况和耐药谱特征。  方法  对广州市某医院艾滋病门诊部HIV感染者鼻腔分离出的CoNS进行药敏试验和耐药基因检测。  结果  1 001名HIV感染者鼻腔CoNS和耐甲氧西林凝固酶阴性葡萄球菌（methicillin-resistant coagulase-negative staphylococci，MRCoNS）携带率分别为57.44%和48.15%，MRCoNS对青霉素、红霉素和复方新诺明耐药率较高，主要携带Aac（6'）-aph（2'）、ermC和linA耐药基因。MRCoNS（80.69%）与甲氧西林敏感凝固酶阴性葡萄球菌（methicillin-susceptible coagulase-negative staphylococci，MSCoNS）（39.66%）多重耐药率差异有统计学意义（χ2=100.27，P < 0.001）。  结论  广州市HIV感染者鼻腔CoNS和MRCoNS携带率及多重耐药率均较高，与MSCoNS相比MRCoNS可增加6.36倍多重耐药风险。
    Abstract:   Objective  We aimed to elucidate the prevalence and the antibiotic resistance spectrum of nasal coagulase-negative staphylococci (CoNS) colonization among HIV infectors in Guangzhou.  Method  After isolation and identification, all CoNS isolates were tested for the antibiotic susceptibility, and the antibiotic resistance genes.  Result  Among the 1 001 HIV infectors, the prevalence of CoNS and MRCoNS were 57.44% and 48.15%, respectively. The three predominant resistant antibiotics of MRCoNS isolates were penicillin, erythromycin and trimethoprim-sulfame thoxazole, while predominant detection rates of genes were Aac(6')-aph(2')、ermC and linA genes. The multidrug resistance rate of MRCoNS isolates were significantly higher than methicillin-susceptible coagulase-negative staphylococci (MSCoNS) isolates (80.69% versus 39.66%, P < 0.001, OR=6.36).  Conclusions  The prevalence and multidrug resistant rates of nasal colonization CoNS and MRCoNS are high among HIV infectors in Guangzhou. MRCoNS isolates were 6.36 times more likely to be of multidrug resistance than MSCoNS isolates.
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  • 表  1  MRCoNS与MSCoNS抗生素耐药情况比较[株(%)]

    Table  1.   Antimicrobial resistance between MRCoNS and MSCoNS [strain (%)]

    抗生素 MRCoNS MSCoNS 合计 χ2值 OR(95%CI)值 P值
    青霉素 432(93.71) 118(67.82) 550(86.61) 73.05 7.07(4.32~11.56) < 0.001
    头孢西丁 352(76.36) 0(0.00) 352(55.43) - 1.00(0.00~+∞) a < 0.001b
    替考拉宁 113(24.51) 32(18.39) 145(22.83) 2.68 1.44(0.93~2.23) 0.101
    庆大霉素 176(38.18) 66(37.93) 242(38.11) 0.00 1.01(0.71~1.45) 0.954
    红霉素 336(72.89) 82(47.13) 418(65.83) 37.26 3.02(2.10~4.33) < 0.001
    四环素 161(34.92) 26(14.94) 187(29.45) 24.28 3.05(1.93~4.83) < 0.001
    莫西沙星 182(39.48) 18(10.34) 200(31.50) 49.70 5.65(3.35~9.53) < 0.001
    呋喃妥因 30(6.51) 5(2.87) 35(5.51) 3.20 2.35(0.90~6.16) 0.073
    克林霉素 155(33.62) 34(19.54) 189(29.76) 11.98 2.09(1.37~3.18) 0.001
    复方新诺明 250(54.23) 39(22.41) 289(45.51) 51.56 4.10(2.75~6.12) < 0.001
    利福平 54(11.71) 10(5.75) 64(10.08) 4.96 2.18(1.08~4.38) 0.026
    利奈唑胺 9(1.95) 0(0.00) 9(1.42) - 4.79(0.75~+∞) a 0.124b
    多重耐药 372(80.69) 69(39.66) 441(69.45) 100.27 6.36(4.34~9.32) < 0.001
      注：a表示使用Exact logistic regression得出OR值和95%CI值；b表示使用Fisher确切概率法。
    下载: 导出CSV

    表  2  MRCoNS与MSCoNS耐药基因及耐消毒基因携带情况比较[株(%)]

    Table  2.   Genetic characteristics between MRCoNS and MSCoNS [strain (%)]

    基因 MRCoNS MSCoNS 合计 χ2值 P值
    耐药基因
    Aac(6’)-aph(2’) 305(66.16) 94(54.02) 399(62.83) 7.97 0.005
    tetM 16(3.47) 5(2.87) 21(3.31) - 0.808a
    tetK 222(48.16) 61(35.06) 283(44.57) 8.77 0.003
    ermA 3(0.65) 0(0.00) 3(0.47) - 0.566a
    ermC 258(55.97) 66(37.93) 324(51.02) 16.44 < 0.001
    linA 227(49.24) 78(44.83) 305(48.03) 0.99 0.321
    耐消毒基因
    qacA/B 243(52.71) 65(37.36) 308(48.50) 11.92 0.001
    smr 49(10.63) 10(5.75) 59(9.29) 3.57 0.059
      注：a表示使用Fisher确切概率法。
    下载: 导出CSV

    表  3  MRCoNS和MSCoNS抗生素种类耐药分布对比[株(%)]

    Table  3.   Antibiotics resistance antibiotics distribution of MRCoNS and MSCoNS [strain(%)]

    耐药类别 MRCoNS MSCoNS 合计 χ2值 P值
    0 4(0.87) 13(7.47) 17(2.68) 21.14 < 0.001
    1 31(6.72) 43(24.71) 74(11.65) 39.70 < 0.001
    2 54(11.71) 49(28.16) 103(16.22) 25.15 < 0.001
    3 98(21.26) 23(13.22) 121(19.06) 5.29 0.021
    4 99(21.48) 22(21.48) 121(19.06) 6.39 0.011
    5 65(14.10) 16(9.20) 81(12.76) 2.73 0.098
    6 59(12.80) 5(2.87) 64(10.08) 13.73 < 0.001
    7 32(6.94) 2(1.15) 34(5.35) 8.36 0.004
    8 12(2.60) 1(0.57) 13(2.05) 2.59 0.107
    9 3(0.65) 0(0.00) 3(0.47) - 0.566a
    10 1(0.22) 0(0.00) 1(0.16) - 1.000a
    11 3(0.65) 0(0.00) 3(0.47) - 0.566a
      注：a表示使用Fisher确切概率法。
    下载: 导出CSV
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  • 收稿日期:  2019-08-17
  • 修回日期:  2019-10-16
  • 刊出日期:  2019-12-10

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