成都地区健康儿童鼻腔社区获得性耐甲氧西林金黄色葡萄球菌的携带研究

Nasal carriage of community-acquired methicillin-resistant Staphylococcus aureus in healthy children from Chengdu

摘要:

目的：调查成都地区健康儿童鼻腔中社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）的携带率。方法：采用横断面调查研究的方法，收集成都市5所幼儿园健康儿童的相关资料及鼻拭子样本，进行细菌培养，使用琼脂纸片扩散法及琼脂稀释法对培养出的金黄色葡萄球菌进行抗生素敏感试验；用PCR方法检测CA-MRSA 菌株mecA耐药基因及PVL毒力基因。结果：共有 801例健康儿童纳入研究，其中金黄色葡萄球菌的携带率为18.4%（147/801）；CA-MRSA的携带率为 1.1%（9/801），并且这9例CA-MRSA全都携带mecA耐药基因，其中有5例CA-MRSA携带PVL基因。9例CA-MRSA中6例为多重耐药。结论：在中国成都市，社区健康儿童已出现CA-MRSA携带者，而且多为多重耐药、部分携带PVL毒力基因。社区健康儿童CA-MRSA的携带已成为值得关注的重要问题。

Abstract:

OBJECTIVE: To evaluate the prevalence of nasal carriage of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) in healthy children from Chengdu. METHODS: Strains of Staphylococcus aureus were isolated from nasal swabs of healthy children from five kindergartens in Chengdu from September, 2005 to December, 2005 and questionnaires were obtained. Antibiotic susceptibility test was performed with agar disk diffusion and Bauer-Kirby on Mueller-Hinton medium method to determine CA-MRSA. mecA and PVL genes were detected with PCR in all of the CA-MRSA isolates. RESULTS: A total of 801 children were enrolled. Overall 147 children (18.4%) were carried with Staphylococcus aureus and 9 (1.1%) were carried with CA-MRSA. All CA-MRSA isolates were positive for mecA gene, and 5 CA-MRSA isolates were positive for PVL gene. Of the 9 CA-MRSA isolates, 6 were multiresistant. CONCLUSIONS: CA-MRSA nasal colonization is present among Chengdu healthy children. The CA-MRSA isolates are multiresistant and parts of CA-MRSA isolates carry PVL gene. The nasal carriage of CA-MRSA in healthy children should be a concerned issue.