CAJ | 학술논문

消毒剂%金黄色葡萄球菌%耐甲氧西林金黄色葡萄球菌%甲氧西林敏感金黄色葡萄球菌%耐消毒剂基因%qacA/B%qacC%qacJ%qacEΔ1%qacG%qac H%norA%Meta 分析消毒劑%金黃色葡萄毬菌%耐甲氧西林金黃色葡萄毬菌%甲氧西林敏感金黃色葡萄毬菌%耐消毒劑基因%qacA/B%qacC%qacJ%qacEΔ1%qacG%qac H%norA%Meta 分析
소독제%금황색포도구균%내갑양서림금황색포도구균%갑양서림민감금황색포도구균%내소독제기인%qacA/B%qacC%qacJ%qacEΔ1%qacG%qac H%norA%Meta 분석
disinfectant%Staphylococcus aureus%methicillin-resistant Staphylococcus aureus%methicillin-sensi-tive Staphylococcus aureus%disinfectant-resistant gene%qacA/B%qacC%qacJ%qacEΔ1%qacG%qac H%norA%Meta-analysis

目的：采用 Meta 分析，综合评价中国耐甲氧西林金黄色葡萄球菌（MRSA）耐消毒剂基因特征。方法计算机检索中国知网（CNKI）、万方医学网、PubMed、EMbase 等数据库，查找中国 MRSA 耐消毒剂基因特征的相关文献，按照统一的纳入与排除标准筛选文献后，采用 R 3．1．1软件、RevMan 5．3软件进行 Meta 分析。结果共纳入42篇文献，我国16个省（直辖市）的2671株 MRSA 耐消毒剂基因情况。Meta 分析结果显示：qacA／B、qacC、qacJ 和norA 基因的合并检出率分别为28．03％（95％CI ：20．03％～36．48％）、8．94％（95％CI ：1．27％～ 22．49％）、17．74％（95％CI ：2．25％～43．39％）和17．90％（95％CI ：0．00％～76．38％）。qacEΔ1、qacG、qacH 的检出率均为0。中国淮河以南、以北地区 qacA／B 基因的合并检出率分别为27．12％（95％ CI ：19．03％～36．06％）和30．14％（95％CI ：13．11％～50．63％），南北地区差异无统计学意义（Z ＝0．59，P ＞0．05）。东部、中部、西部经济区域的qacA／B基因的合并检出率分别为29．95％（95％CI ：21．85％～38．73％）、22．65％（95％ CI ：10．08％～38．47％）和26．94％（95％CI ：3．78％～60．95％），组间差异均无统计学意义（P ＞0．05）。医院获得性 MRSA 与社区获得性 MRSA qacA／B 基因检出率比较，差异无统计学意义[OR 及95％CI 为0．69（0．14～3．31），P ＝0．64]。MRSA qacA／B 基因检出率高于甲氧西林敏感金黄色葡萄球菌（MSSA）[OR 及95％CI 为4．99（3．53～7．06），P ＜0．01]。结论中国MRSA 耐消毒剂基因检出率高，MRSA 耐消毒剂基因是一个常见且严重的问题，应加强耐消毒剂基因的监测，合理使用消毒剂。
목적：채용 Meta 분석，종합평개중국내갑양서림금황색포도구균（MRSA）내소독제기인특정。방법계산궤검색중국지망（CNKI）、만방의학망、PubMed、EMbase 등수거고，사조중국 MRSA 내소독제기인특정적상관문헌，안조통일적납입여배제표준사선문헌후，채용 R 3．1．1연건、RevMan 5．3연건진행 Meta 분석。결과공납입42편문헌，아국16개성（직할시）적2671주 MRSA 내소독제기인정황。Meta 분석결과현시：qacA／B、qacC、qacJ 화norA 기인적합병검출솔분별위28．03％（95％CI ：20．03％～36．48％）、8．94％（95％CI ：1．27％～ 22．49％）、17．74％（95％CI ：2．25％～43．39％）화17．90％（95％CI ：0．00％～76．38％）。qacEΔ1、qacG、qacH 적검출솔균위0。중국회하이남、이북지구 qacA／B 기인적합병검출솔분별위27．12％（95％ CI ：19．03％～36．06％）화30．14％（95％CI ：13．11％～50．63％），남북지구차이무통계학의의（Z ＝0．59，P ＞0．05）。동부、중부、서부경제구역적qacA／B기인적합병검출솔분별위29．95％（95％CI ：21．85％～38．73％）、22．65％（95％ CI ：10．08％～38．47％）화26．94％（95％CI ：3．78％～60．95％），조간차이균무통계학의의（P ＞0．05）。의원획득성 MRSA 여사구획득성 MRSA qacA／B 기인검출솔비교，차이무통계학의의[OR 급95％CI 위0．69（0．14～3．31），P ＝0．64]。MRSA qacA／B 기인검출솔고우갑양서림민감금황색포도구균（MSSA）[OR 급95％CI 위4．99（3．53～7．06），P ＜0．01]。결론중국MRSA 내소독제기인검출솔고，MRSA 내소독제기인시일개상견차엄중적문제，응가강내소독제기인적감측，합리사용소독제。
Objective To evaluate the features of disinfectant-resistant genes in methicillin-resistant Staphylococ-cus aureus (MRSA)in China through Meta-analysis.Methods Literatures about features of disinfectant-resistant genes in MRSA were searched from China National Knowledge Infrastructure (CNKI),Wanfang Med Online, PubMed,and Excerpta Medica Database (EMbase)through computerized retrieval system,literatures were selected according to standard inclusion and exclusion criteria,Meta-analysis was performed using R3.1 .1 software and Rev-Man 5.3 software.Results A total of 42 literatures were included,involving disinfectant-resistant genes of 2 671 strains of MRSA from 16 provinces (municipalities)in China.The overall detection rate of qacA/B,qacC,qacJ and norA was 28.03%(95%CI :20.03%-36.48%),8.94%(95%CI :1 .27%-22.49%),17.74%(95%CI :2.25%-43.39%),and 17.90% (95%CI :0.00% -76.38%)respectively.The detection rates of qacEΔ1 ,qacG,and qac H were 0.00%.The overall detection rate of qacA/B of the southern and northern China areas was 27.12% <br> (95%CI :19.03% -36.06%)and 30.14% (95%CI :13.11 % -50.63%)respectively,there was no statistical difference between two areas (Z =0.59,P >0.05).The overall detection rate of qacA/B in the eastern,central and western economic region was 29.95% (95%CI :21 .85%-38.73%),22.65% (95%CI :10.08%-38.47%),and 26.94% (95%CI :3.78% -60.95%)respectively,there was no statistical difference among these regions (P >0.05).The detection rates of qacA/B in hospital-acquired (HA)-MRSA and community-acquired (CA)-MRSA were not statistically different (OR and 95%CI =0.69[0.14-3.31 ],P =0.64).The detection rate of qacA/B in MRSA was higher than those in methicillin-sensitive Staphylococcus aureus (MSSA)(OR and 95%CI =4.99[3.53-7.06],P <0.01).Conclusion Detection rate of disinfectant-resistant genes in MRSA is high in China,which is common and serious ,monitoring on disinfectant-resistant genes should be enhanced,disinfectants should be used rationally.