实时荧光 PCR 检测 MRSA 对减少儿科 ICU 病区医院感染的效果观察

摘要

Objective To reduce nosocomial infection of meticillin-resistant staphylococcus aureus( MRSA) in pediatric intensive care unit(PICU) by real-time fluorescence PCR.Methods From July 2011 to June 2012, 856 specimens in PICU were detected for MRSA by using real-time fluorescence PCR and isolation-culture-K-B paper disk diffusion method.The nosocomial infection rate during the period from July 2009 to June 2010 was compared with that from July 2011 to June 2012.Results Thirty-three strains of staphylococcus aureus were identified by culture and re-al-time fluorescence PCR.Of the 33 clinical isolated staphylococcus aureus, 12 isolates were defined as MRSA by K-B paper disk diffusion method and 14 isolates were defined as MRSA by real-time fluorescence PCR.The two isolates which were defined as positive by real-time fluorescence PCR and negative by K-B paper disk diffusion method were proved to be MRSA positive by sequencing method.Nosocomial infection rates reduced from 36.4%, 37.5% to 16.7%.Conclusion The real-time fluorescence PCR can identify MRSA more rapidly and accurately and help re-duce the rate of nosocomial infection of MRSA in PICU.%目的：观察实时荧光PCR检测耐甲氧西林金黄色葡萄球菌（ MRSA）对减少儿科ICU病区医院感染的效果。方法选取2011-07～2012-06实时荧光PCR法检测的儿科ICU病区标本856份，其结果与分离培养药敏试验法的检测结果进行比较；另与2009-07～2010-06 MRSA医院感染率进行比较。结果实时荧光PCR法与分离培养药敏试验法对金葡菌检测的一致率为100％，均检测出33株金葡菌阳性株。实时荧光PCR法与分离培养药敏试验法检测MRSA的符合率为93.9％。分离培养药敏试验法检测为阴性而实时荧光PCR法检测为阳性的2株待检菌的测序结果显示为阳性。利用实时荧光PCR法检测MRSA后，医院感染率从36.4％下降到16.7％。结论实时荧光PCR法能更及时、更准确发现MRSA，从而早隔离、早治疗，减少MRSA医院感染。