实验与检验医学
實驗與檢驗醫學
실험여검험의학
EXPERIMENTAL AND LABORATORY MEDICINE
2014年
4期
392-394
,共3页
耐甲氧西林金黄色葡萄球菌%头孢西丁%苯唑西林
耐甲氧西林金黃色葡萄毬菌%頭孢西丁%苯唑西林
내갑양서림금황색포도구균%두포서정%분서서림
Methicillin-resistant Staphylococcus aureus%Cefoxitin%Oxacillin
目的：通过对本院医生、护士及护理员的手及鼻咽前庭进行耐甲氧西林金黄色葡萄球菌(MRSA)检出情况的分析，比较两种检验方法MRSA的检出效果。方法将医护人员的678例手标本及179例鼻咽前庭标本分别用两种检验方法进行MRSA鉴定，一种将标本用血平板分离培养初筛后，再用全自动微生物鉴定仪进行菌种鉴定，同时用头孢西丁(30μg/片)和苯唑西林(1μg/片)纸片扩散法按2010年美国CLSI抗菌药物敏感试验标准进行药物敏感试验鉴定MRSA，此传统检测方法为本实验的参考方法，结果准确可靠，另一种将标本直接接种于MRSA选择性显色培养基上，根据判定说明书观察在培养基上金黄色葡萄球菌的生长情况鉴定MRSA，此为快速检测方法，并进行两种方法MRSA检出效果的比较。结果传统检测方法检出手标本有5株MRSA，44株甲氧西林敏感金黄色葡萄球菌(MSSA)，鼻咽前庭拭子标本有3株MRSA，22株MSSA；快速检测方法检出手标本有6株MRSA，43株MSSA，鼻咽前庭拭子标本有3株MRSA，22株MSSA。结论采用MRSA选择性显色培养基方法与传统检测方法比较，手标本检出MRSA的总符合率为95.9%，鼻咽前庭标本检出MRSA的总符合率为100%，两种检测方法对于MRSA及MSSA检出结果均无显著性差异(P>0.05)，由于其操作简便，特异性高，适合于在各级临床实验室广泛推广用于鉴定MRSA。
目的：通過對本院醫生、護士及護理員的手及鼻嚥前庭進行耐甲氧西林金黃色葡萄毬菌(MRSA)檢齣情況的分析，比較兩種檢驗方法MRSA的檢齣效果。方法將醫護人員的678例手標本及179例鼻嚥前庭標本分彆用兩種檢驗方法進行MRSA鑒定，一種將標本用血平闆分離培養初篩後，再用全自動微生物鑒定儀進行菌種鑒定，同時用頭孢西丁(30μg/片)和苯唑西林(1μg/片)紙片擴散法按2010年美國CLSI抗菌藥物敏感試驗標準進行藥物敏感試驗鑒定MRSA，此傳統檢測方法為本實驗的參攷方法，結果準確可靠，另一種將標本直接接種于MRSA選擇性顯色培養基上，根據判定說明書觀察在培養基上金黃色葡萄毬菌的生長情況鑒定MRSA，此為快速檢測方法，併進行兩種方法MRSA檢齣效果的比較。結果傳統檢測方法檢齣手標本有5株MRSA，44株甲氧西林敏感金黃色葡萄毬菌(MSSA)，鼻嚥前庭拭子標本有3株MRSA，22株MSSA；快速檢測方法檢齣手標本有6株MRSA，43株MSSA，鼻嚥前庭拭子標本有3株MRSA，22株MSSA。結論採用MRSA選擇性顯色培養基方法與傳統檢測方法比較，手標本檢齣MRSA的總符閤率為95.9%，鼻嚥前庭標本檢齣MRSA的總符閤率為100%，兩種檢測方法對于MRSA及MSSA檢齣結果均無顯著性差異(P>0.05)，由于其操作簡便，特異性高，適閤于在各級臨床實驗室廣汎推廣用于鑒定MRSA。
목적：통과대본원의생、호사급호리원적수급비인전정진행내갑양서림금황색포도구균(MRSA)검출정황적분석，비교량충검험방법MRSA적검출효과。방법장의호인원적678례수표본급179례비인전정표본분별용량충검험방법진행MRSA감정，일충장표본용혈평판분리배양초사후，재용전자동미생물감정의진행균충감정，동시용두포서정(30μg/편)화분서서림(1μg/편)지편확산법안2010년미국CLSI항균약물민감시험표준진행약물민감시험감정MRSA，차전통검측방법위본실험적삼고방법，결과준학가고，령일충장표본직접접충우MRSA선택성현색배양기상，근거판정설명서관찰재배양기상금황색포도구균적생장정황감정MRSA，차위쾌속검측방법，병진행량충방법MRSA검출효과적비교。결과전통검측방법검출수표본유5주MRSA，44주갑양서림민감금황색포도구균(MSSA)，비인전정식자표본유3주MRSA，22주MSSA；쾌속검측방법검출수표본유6주MRSA，43주MSSA，비인전정식자표본유3주MRSA，22주MSSA。결론채용MRSA선택성현색배양기방법여전통검측방법비교，수표본검출MRSA적총부합솔위95.9%，비인전정표본검출MRSA적총부합솔위100%，량충검측방법대우MRSA급MSSA검출결과균무현저성차이(P>0.05)，유우기조작간편，특이성고，괄합우재각급림상실험실엄범추엄용우감정MRSA。
Objective To analysis the detection of methicillin-resistant Staphylococcus aureus (MRSA) from the hands and nasal vestibular of doctors, nurses and attendants, and compare the detection effect for MRSA of two kinds of test methods. Meth-ods A total of 678 hand specimens and 179 nasopharyngeal vestibular specimens of medical staffs were treated with two kinds of test methods for identification of MRSA. Firstly, we collected specimens with blood agar plates and then identified the strains by automatic microorganism instrument after screening. At the same time, the drug sensitivity tests with cefoxitin (30μg/) and oxacillin (1μg/) were performed by K-B disk diffusion method for identification of MRSA;meanwhile, all the specimens were directly inoc-ulated on MRSA selective chromogenic medium to identify MRSA. At last, the effects of two test methods for identification of MR-SA were compared. Results A total of 5 strains of MRSA and 44 strains of methicillin sensitive Staphylococcus aureus (MSSA) were detected in the hand specimens, also 3 strains of MRSA and 22 strains of MSSA were detected in the nasopharyngeal vestibu-lar specimens by using the traditional method;6 strains of MRSA and 43 strains of MSSA were detected in the hand specimens, 3 strains of MRSA and 22 strains of MSSA were detected in the nasopharyngeal vestibular specimens by using the rapid method. Conclusion Comparing with the traditional detection method, the total coincidence rate of the rapid method for MRSA identifica-tion was 95.9% in the hand specimens and 100% in the nasopharyngeal vestibular specimens. The detection results of two test methods for MRSA and MSSA showed no significant difference(P>0.05). Because of the simple operation and high specificity of the rapid method, it is suitable for popularization in clinical laboratory for identification of MRSA.
