Survey on high incidence rate and molecular epidemiology of methicillin-resistant <i>Staphylococcus aureus</i> in general surgery of a hospital_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HE Jianchun ¹ , PEI Changzhen ² , YANG Lei ¹ , WANG Dan ¹ ,  CHEN Hongyou ¹

1. Department of Clinical Laboratory, Peoples’s Hospital of Dazu District, Dazu, Chongqing 402360, P. R. China;
2. Sleep Psychosomatic Center, Peoples’s Hospital of Dazu District, Dazu, Chongqing 402360, P. R. China;

Corresponding author：

CHEN Hongyou, Email: 757360482@qq.com

Keywords：

Staphylococcus aureus; methicillin-resistant Staphylococcus aureus; general surgery; multilocus sequence typing

DOI：

10.7507/1007-9424.202109098

Video：

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Objective To investigate the incidence rate, molecular epidemiology and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) infection. Methods A total of 119 Staphylococcus aureus strains isolated from January 2016 to December 2020 in general surgery of this hospital were collected retrospectively and divided into MRSA group and methicillin-sensitive Staphylococcus aureus group according to whether or not resistant to oxacillin. The clinical data of all patients infected with Staphylococcus aureus and drug sensitivity of Staphylococcus aureus were collected. Molecular typing was performed by multilocus sequence typing (MLST), resistance gene, virulence gene and biofilm gene were detected by polymerase chain reaction (PCR) method, and a case-control study was used to identify risk factors for MRSA infection. Results The detection rate of MRSA was 57.98% (69/119), mainly was from pus specimens (80.67%, 96/119). The results of MLST showed that the dominant clone types were ST88 (37.68%, 26/69), ST951 (27.54%, 19/69) and ST59 (18.84%, 13/69). The results of PCR showed that the detection rates of mecA, mecC, Aac (6′ )/Aph (2′ ′ ), Aph (3)-Ⅲ, ant (4′ )- Ⅰ a, tetM, qnrA, panton-valentine leukocidin, fibronectin-binding protein A, staphylococcal enterotoxin A, staphylococcal enterotoxin B, α-hemolysins, intracellular adhesion A, staphylococcal accessory regulators A, and fibronectin-binding protein B in 69 strains of MRSA were 100%, 0.00%, 27.54%, 34.78%, 18.84%, 14.49%, 1.45%, 8.70%, 98.55%, 11.59%, 91.30%, 94.20%, 92.75%, 97.10% and 86.96%, respectively. Multivariate analysis showed that hospital transfer, wound infection, catheter related infection, drainage tube and history of cephalosporin using were risk factors for MRSA infection. Conclusions The detection rate of MRSA in general surgery of this hospital is high. ST88 is the most common clone type. The carrying rates of resistant-, virulence- and biofilm-related genes are high. Hospital transfer, wound infection, drainage tube, history of cephalosporin using etc. are high risk factors for MRSA infection. It is advised that invasive operation should be reduced, antibiotics should be used rationally, hand hygiene should be paid attention to, environmental sanitation disinfection should be carried out regularly, and the monitoring of MRSA bacteria should be strengthened, so as to reduce and control the infection and spread of MRSA.

Citation： HE Jianchun, PEI Changzhen, YANG Lei, WANG Dan, CHEN Hongyou. Survey on high incidence rate and molecular epidemiology of methicillin-resistant Staphylococcus aureus in general surgery of a hospital. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(7): 897-903. doi: 10.7507/1007-9424.202109098 Copy

1.	陈静, 吴佳玉, 向钱, 等. 金黄色葡萄球菌血流感染139例临床分析. 中国感染与化疗杂志, 2020, 20(4): 368-373.
2.	崔颖鹏, 冯冰, 彭雅琴, 等. 广州市96株血流感染金黄色葡萄球菌的基因分型及耐药性分析. 中国热带医学, 2021, 21(12): 1174-1177.
3.	张杰. 皮肤软组织感染耐甲氧西林金黄色葡萄球菌的分子特征和耐药性研究. 南昌: 南昌大学, 2020.
4.	Tsuzuki S, Yu J, Matsunaga N, et al. Length of stay, hospitalisation costs and in-hospital mortality of methicillin-susceptible and methicillin-resistant Staphylococcus aureus bacteremia in Japan. Public health, 2021, 198: 292-296.
5.	Chuang YY, Huang YC. Molecular epidemiology of community-associated meticillin-resistant Staphylococcus aureus in Asia. Lancet Infect Dis, 2013, 13(8): 698-708.
6.	Choe D, Szubin R, Dahesh S, et al. Genome-scale analysis of methicillin-resistant Staphylococcus aureus USA300 reveals a tradeoff between pathogenesis and drug resistance. Sci Rep, 2018, 8(1): 2215. doi: 10.1038/s41598-018-20661-1.
7.	Rolo J, Miragaia M, Turlej-Rogacka A, et al. High genetic diversity among community-associated Staphylococcus aureus in Europe: results from a multicenter study. PLoS One, 2012, 7(4): e34768. doi: 10.1371/journal.pone.0034768.
8.	胡付品, 郭燕, 朱德妹, 等. 2005-2014年CHINET中国细菌耐药性监测网5种重要临床分离菌的耐药性变迁. 中国感染与化疗杂志, 2017, 17(1): 93-99.
9.	胡付品, 郭燕, 朱德妹, 等. 2018年CHINET中国细菌耐药性监测. 中国感染与化疗杂志, 2020, 20(1): 1-10.
10.	尚红, 王毓三, 申子瑜. 全国临床检验操作规程. 第4版. 北京: 人民卫生出版社, 2015: 629-645.
11.	储丹丹. 耐甲氧西林金黄色葡萄球菌耐药、毒力、生物膜相关基因分析及分子分型研究. 昆明: 昆明医科大学, 2020.
12.	何建春, 赵峻英, 董剑, 等. 重症监护室耐头孢吡肟铜绿假单胞菌的分子流行病学调查. 临床急诊杂志, 2021, 22(2): 131-136.
13.	蒋丽迁, 韩松花, 李雪飞, 等. 骨科患者术后皮肤及软组织感染分离金黄色葡萄球菌耐药基因. 中华医院感染学杂志, 2021, 31(20): 3153-3156.
14.	周瑾, 王山梅, 刘燕梅, 等. 金黄色葡萄球菌术后切口感染86例临床特征分析. 中国感染与化疗杂志, 2021, 21(5): 536-540.
15.	杨毅, 牟文婷, 田居灵, 等. 住院患儿耐甲氧西林金黄色葡萄球菌的PFGE分型及耐药性. 医学动物防制, 2020, 36(3): 257-260.
16.	汤兰兰. 贵州省某三甲医院耐甲氧西林金黄色葡萄球菌常见耐药基因检测及同源性分析. 遵义: 遵义医科大学, 2019.
17.	于志君, 唐诗, 邓雪丹, 等. 3种抗菌药治疗耐甲氧西林金黄色葡萄球菌肺炎的网状Meta分析. 解放军医学院学报, 2020, 41(9): 905-912.
18.	Liu JL, Li TM, Zhong N, et al. Current status of oxacillin-susceptible mecA-positive Staphylococcus aureus infection in Shanghai, China: A multicenter study. J Microbiol Immunol Infect, 2021, 54(6): 1070-1077.
19.	Jeon H, Ma SH, Jo HJ, et al. Long-term persistence of sequence type 89 methicillin-resistant Staphylococcus aureus isolated from cases of staphylococcal scalded skin syndrome in a Korean community. J Med Microbiol, 2016, 65(12): 1542-1544.
20.	Bispo PJM, Ung L, Chodosh J, et al. Hospital-associated multidrug-resistant MRSA lineages are trophic to the ocular surface and cause severe microbial keratitis. Front Public Health, 2020, 8: 204. doi: 10.3389/fpubh.2020.00204.
21.	Hauschild T, Sacha P, Wieczorek P, et al. Aminoglycosides resistance in clinical isolates of S. aureus from a University Hospital in Bialystok, Poland. Folia Histochem Cytobiol, 2008, 46(2): 225-228.
22.	Atshan SS, Shamsudin MN, Sekawi Z, et al. Prevalence of adhesion and regulation of biofilm-related genes in different clones of Staphylococcus aureus. J Biomed Biotechnol, 2012, 2012: 976972. doi: 10.1155/2012/976972.
23.	诸葛石养, 苏爱荣, 黄彦, 等. 金黄色葡萄球菌β溶血素研究进展. 右江医学, 2021, 49(6): 473-476.
24.	Rosengren A, Lindblad M, Lindqvist R. The effect of undissociated lactic acid on Staphylococcus aureus growth and enterotoxin A production. Int J Food Microbiol, 2013, 162(2): 159-166.
25.	夏运, 刘华. 重症监护患者耐甲氧西林金黄色葡萄球菌感染高危因素研究. 南通大学学报(医学版), 2019, 39(4): 319-321.
26.	汪轩轩, 黄颖, 胡媛媛, 等. 皮肤软组织感染耐甲氧西林金黄色葡萄球菌SCC mec分型和同源性分析. 安徽医科大学学报, 2021, 56(10): 1565-1569.
27.	张彦武, 吕以东, 牛耀东, 等. 静脉留置针持续引流在MRSA感染性乳腺脓肿中的应用. 中国普外基础与临床杂志, 2017, 24(4): 478-481.

1. 陈静, 吴佳玉, 向钱, 等. 金黄色葡萄球菌血流感染139例临床分析. 中国感染与化疗杂志, 2020, 20(4): 368-373.
2. 崔颖鹏, 冯冰, 彭雅琴, 等. 广州市96株血流感染金黄色葡萄球菌的基因分型及耐药性分析. 中国热带医学, 2021, 21(12): 1174-1177.
3. 张杰. 皮肤软组织感染耐甲氧西林金黄色葡萄球菌的分子特征和耐药性研究. 南昌: 南昌大学, 2020.
4. Tsuzuki S, Yu J, Matsunaga N, et al. Length of stay, hospitalisation costs and in-hospital mortality of methicillin-susceptible and methicillin-resistant Staphylococcus aureus bacteremia in Japan. Public health, 2021, 198: 292-296.
5. Chuang YY, Huang YC. Molecular epidemiology of community-associated meticillin-resistant Staphylococcus aureus in Asia. Lancet Infect Dis, 2013, 13(8): 698-708.
6. Choe D, Szubin R, Dahesh S, et al. Genome-scale analysis of methicillin-resistant Staphylococcus aureus USA300 reveals a tradeoff between pathogenesis and drug resistance. Sci Rep, 2018, 8(1): 2215. doi: 10.1038/s41598-018-20661-1.
7. Rolo J, Miragaia M, Turlej-Rogacka A, et al. High genetic diversity among community-associated Staphylococcus aureus in Europe: results from a multicenter study. PLoS One, 2012, 7(4): e34768. doi: 10.1371/journal.pone.0034768.
8. 胡付品, 郭燕, 朱德妹, 等. 2005-2014年CHINET中国细菌耐药性监测网5种重要临床分离菌的耐药性变迁. 中国感染与化疗杂志, 2017, 17(1): 93-99.
9. 胡付品, 郭燕, 朱德妹, 等. 2018年CHINET中国细菌耐药性监测. 中国感染与化疗杂志, 2020, 20(1): 1-10.
10. 尚红, 王毓三, 申子瑜. 全国临床检验操作规程. 第4版. 北京: 人民卫生出版社, 2015: 629-645.
11. 储丹丹. 耐甲氧西林金黄色葡萄球菌耐药、毒力、生物膜相关基因分析及分子分型研究. 昆明: 昆明医科大学, 2020.
12. 何建春, 赵峻英, 董剑, 等. 重症监护室耐头孢吡肟铜绿假单胞菌的分子流行病学调查. 临床急诊杂志, 2021, 22(2): 131-136.
13. 蒋丽迁, 韩松花, 李雪飞, 等. 骨科患者术后皮肤及软组织感染分离金黄色葡萄球菌耐药基因. 中华医院感染学杂志, 2021, 31(20): 3153-3156.
14. 周瑾, 王山梅, 刘燕梅, 等. 金黄色葡萄球菌术后切口感染86例临床特征分析. 中国感染与化疗杂志, 2021, 21(5): 536-540.
15. 杨毅, 牟文婷, 田居灵, 等. 住院患儿耐甲氧西林金黄色葡萄球菌的PFGE分型及耐药性. 医学动物防制, 2020, 36(3): 257-260.
16. 汤兰兰. 贵州省某三甲医院耐甲氧西林金黄色葡萄球菌常见耐药基因检测及同源性分析. 遵义: 遵义医科大学, 2019.
17. 于志君, 唐诗, 邓雪丹, 等. 3种抗菌药治疗耐甲氧西林金黄色葡萄球菌肺炎的网状Meta分析. 解放军医学院学报, 2020, 41(9): 905-912.
18. Liu JL, Li TM, Zhong N, et al. Current status of oxacillin-susceptible mecA-positive Staphylococcus aureus infection in Shanghai, China: A multicenter study. J Microbiol Immunol Infect, 2021, 54(6): 1070-1077.
19. Jeon H, Ma SH, Jo HJ, et al. Long-term persistence of sequence type 89 methicillin-resistant Staphylococcus aureus isolated from cases of staphylococcal scalded skin syndrome in a Korean community. J Med Microbiol, 2016, 65(12): 1542-1544.
20. Bispo PJM, Ung L, Chodosh J, et al. Hospital-associated multidrug-resistant MRSA lineages are trophic to the ocular surface and cause severe microbial keratitis. Front Public Health, 2020, 8: 204. doi: 10.3389/fpubh.2020.00204.
21. Hauschild T, Sacha P, Wieczorek P, et al. Aminoglycosides resistance in clinical isolates of S. aureus from a University Hospital in Bialystok, Poland. Folia Histochem Cytobiol, 2008, 46(2): 225-228.
22. Atshan SS, Shamsudin MN, Sekawi Z, et al. Prevalence of adhesion and regulation of biofilm-related genes in different clones of Staphylococcus aureus. J Biomed Biotechnol, 2012, 2012: 976972. doi: 10.1155/2012/976972.
23. 诸葛石养, 苏爱荣, 黄彦, 等. 金黄色葡萄球菌β溶血素研究进展. 右江医学, 2021, 49(6): 473-476.
24. Rosengren A, Lindblad M, Lindqvist R. The effect of undissociated lactic acid on Staphylococcus aureus growth and enterotoxin A production. Int J Food Microbiol, 2013, 162(2): 159-166.
25. 夏运, 刘华. 重症监护患者耐甲氧西林金黄色葡萄球菌感染高危因素研究. 南通大学学报(医学版), 2019, 39(4): 319-321.
26. 汪轩轩, 黄颖, 胡媛媛, 等. 皮肤软组织感染耐甲氧西林金黄色葡萄球菌SCC mec分型和同源性分析. 安徽医科大学学报, 2021, 56(10): 1565-1569.
27. 张彦武, 吕以东, 牛耀东, 等. 静脉留置针持续引流在MRSA感染性乳腺脓肿中的应用. 中国普外基础与临床杂志, 2017, 24(4): 478-481.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Survey on high incidence rate and molecular epidemiology of methicillin-resistant Staphylococcus aureus in general surgery of a hospital

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