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.	陳靜, 吳佳玉, 向錢, 等. 金黃色葡萄球菌血流感染139例臨床分析. 中國感染與化療雜志, 2020, 20(4): 368-373.
2.	崔穎鵬, 馮冰, 彭雅琴, 等. 廣州市96株血流感染金黃色葡萄球菌的基因分型及耐藥性分析. 中國熱帶醫學, 2021, 21(12): 1174-1177.
3.	張杰. 皮膚軟組織感染耐甲氧西林金黃色葡萄球菌的分子特征和耐藥性研究. 南昌: 南昌大學, 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中國細菌耐藥性監測網5種重要臨床分離菌的耐藥性變遷. 中國感染與化療雜志, 2017, 17(1): 93-99.
9.	胡付品, 郭燕, 朱德妹, 等. 2018年CHINET中國細菌耐藥性監測. 中國感染與化療雜志, 2020, 20(1): 1-10.
10.	尚紅, 王毓三, 申子瑜. 全國臨床檢驗操作規程. 第4版. 北京: 人民衛生出版社, 2015: 629-645.
11.	儲丹丹. 耐甲氧西林金黃色葡萄球菌耐藥、毒力、生物膜相關基因分析及分子分型研究. 昆明: 昆明醫科大學, 2020.
12.	何建春, 趙峻英, 董劍, 等. 重癥監護室耐頭孢吡肟銅綠假單胞菌的分子流行病學調查. 臨床急診雜志, 2021, 22(2): 131-136.
13.	蔣麗遷, 韓松花, 李雪飛, 等. 骨科患者術后皮膚及軟組織感染分離金黃色葡萄球菌耐藥基因. 中華醫院感染學雜志, 2021, 31(20): 3153-3156.
14.	周瑾, 王山梅, 劉燕梅, 等. 金黃色葡萄球菌術后切口感染86例臨床特征分析. 中國感染與化療雜志, 2021, 21(5): 536-540.
15.	楊毅, 牟文婷, 田居靈, 等. 住院患兒耐甲氧西林金黃色葡萄球菌的PFGE分型及耐藥性. 醫學動物防制, 2020, 36(3): 257-260.
16.	湯蘭蘭. 貴州省某三甲醫院耐甲氧西林金黃色葡萄球菌常見耐藥基因檢測及同源性分析. 遵義: 遵義醫科大學, 2019.
17.	于志君, 唐詩, 鄧雪丹, 等. 3種抗菌藥治療耐甲氧西林金黃色葡萄球菌肺炎的網狀Meta分析. 解放軍醫學院學報, 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.	諸葛石養, 蘇愛榮, 黃彥, 等. 金黃色葡萄球菌β溶血素研究進展. 右江醫學, 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.	夏運, 劉華. 重癥監護患者耐甲氧西林金黃色葡萄球菌感染高危因素研究. 南通大學學報(醫學版), 2019, 39(4): 319-321.
26.	汪軒軒, 黃穎, 胡媛媛, 等. 皮膚軟組織感染耐甲氧西林金黃色葡萄球菌SCC mec分型和同源性分析. 安徽醫科大學學報, 2021, 56(10): 1565-1569.
27.	張彥武, 呂以東, 牛耀東, 等. 靜脈留置針持續引流在MRSA感染性乳腺膿腫中的應用. 中國普外基礎與臨床雜志, 2017, 24(4): 478-481.

1. 陳靜, 吳佳玉, 向錢, 等. 金黃色葡萄球菌血流感染139例臨床分析. 中國感染與化療雜志, 2020, 20(4): 368-373.
2. 崔穎鵬, 馮冰, 彭雅琴, 等. 廣州市96株血流感染金黃色葡萄球菌的基因分型及耐藥性分析. 中國熱帶醫學, 2021, 21(12): 1174-1177.
3. 張杰. 皮膚軟組織感染耐甲氧西林金黃色葡萄球菌的分子特征和耐藥性研究. 南昌: 南昌大學, 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中國細菌耐藥性監測網5種重要臨床分離菌的耐藥性變遷. 中國感染與化療雜志, 2017, 17(1): 93-99.
9. 胡付品, 郭燕, 朱德妹, 等. 2018年CHINET中國細菌耐藥性監測. 中國感染與化療雜志, 2020, 20(1): 1-10.
10. 尚紅, 王毓三, 申子瑜. 全國臨床檢驗操作規程. 第4版. 北京: 人民衛生出版社, 2015: 629-645.
11. 儲丹丹. 耐甲氧西林金黃色葡萄球菌耐藥、毒力、生物膜相關基因分析及分子分型研究. 昆明: 昆明醫科大學, 2020.
12. 何建春, 趙峻英, 董劍, 等. 重癥監護室耐頭孢吡肟銅綠假單胞菌的分子流行病學調查. 臨床急診雜志, 2021, 22(2): 131-136.
13. 蔣麗遷, 韓松花, 李雪飛, 等. 骨科患者術后皮膚及軟組織感染分離金黃色葡萄球菌耐藥基因. 中華醫院感染學雜志, 2021, 31(20): 3153-3156.
14. 周瑾, 王山梅, 劉燕梅, 等. 金黃色葡萄球菌術后切口感染86例臨床特征分析. 中國感染與化療雜志, 2021, 21(5): 536-540.
15. 楊毅, 牟文婷, 田居靈, 等. 住院患兒耐甲氧西林金黃色葡萄球菌的PFGE分型及耐藥性. 醫學動物防制, 2020, 36(3): 257-260.
16. 湯蘭蘭. 貴州省某三甲醫院耐甲氧西林金黃色葡萄球菌常見耐藥基因檢測及同源性分析. 遵義: 遵義醫科大學, 2019.
17. 于志君, 唐詩, 鄧雪丹, 等. 3種抗菌藥治療耐甲氧西林金黃色葡萄球菌肺炎的網狀Meta分析. 解放軍醫學院學報, 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. 諸葛石養, 蘇愛榮, 黃彥, 等. 金黃色葡萄球菌β溶血素研究進展. 右江醫學, 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. 夏運, 劉華. 重癥監護患者耐甲氧西林金黃色葡萄球菌感染高危因素研究. 南通大學學報(醫學版), 2019, 39(4): 319-321.
26. 汪軒軒, 黃穎, 胡媛媛, 等. 皮膚軟組織感染耐甲氧西林金黃色葡萄球菌SCC mec分型和同源性分析. 安徽醫科大學學報, 2021, 56(10): 1565-1569.
27. 張彥武, 呂以東, 牛耀東, 等. 靜脈留置針持續引流在MRSA感染性乳腺膿腫中的應用. 中國普外基礎與臨床雜志, 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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