【摘要】 目的 分析联勤保障部队第九〇〇医院2017—2023年耐甲氧西林金黄色葡萄球菌(MRSA)检出特点、耐药性及耐药基因携带情况，为临床防治MRSA提供实验依据。方法 回顾性分析2017—2023年检出的金黄色葡萄球菌(SA)的临床分布和耐药情况，通过聚合酶链式反应(PCR)检测324株MRSA分离株5种耐药基因携带情况。结果 2017—2023年共检出SA 3 086株，其中1 054株为MRSA(34.15%)。MRSA主要由神经外科(18.22%)、骨科(14.23%)及普通外科(11.57%)送检，检出占比最高的标本类型是分泌物(39.09%)和痰液(20.97%)。MRSA对红霉素、克林霉素、四环素、环丙沙星、庆大霉素、莫西沙星、复方新诺明、利福平存在不同程度的耐药性，其中对红霉素和克林霉素的耐药率较高(>70%),未检出对万古霉素和利奈唑胺耐药的MRSA菌株。耐药基因mecA、tetM、aac、ermA、ermC的检出率分别为100.00%、20.37%、99.69%、70.99%、99.38%。结论 MRSA检出率较高，对常用抗生素有不同程度的耐药并携带多种耐药基因，临床应结合药敏试验和基因检测结果合理使用抗生素，以减少多重耐药菌的出现。更多还原

【Abstract】 Objective To analyze the detection characteristics, drug resistance and resistance genes carrier of methicillin-resistant staphylococcus aureus(MRSA) in the 900th Hospital of the Joint Service Support Force from 2017 to 2023, so as to provide experimental basis for clinical prevention and treatment of MRSA. Methods The clinical distribution and drug resistance of staphylococcus aureus(SA) detected from 2017 to 2023 were retrospectively analyzed. Five resistance genes of 324 MRSA isolates were detected by polymerase chain reaction(PCR). Results A total of 3 086 strains of SA were detected from 2017 to 2023, of which 1 054 were MRSA(34.15%). MRSA was mainly sent by Neurosurgery(18.22%), Orthopedics(14.23%) and General Surgery(11.57%), and the specimens with the highest proportion were secretions(39.09%) and sputum(20.97%). MRSA was resistant to erythromycin, clindamycin, tetracycline, ciprofloxacin, gentamicin, moxifloxacin, cotrimoxazole and rifampicin to varying degrees, among which the resistance rate to erythromycin and clindamycin was higher(>70%), and no MRSA strains resistant to vancomycin and linezolid were detected. The detection rates of resistance genes of mecA, tetM, aac, ermA and ermC were 100.00%, 20.37%, 99.69%, 70.99% and 99.38%, respectively. Conclusion The detection rate is relatively high, and it has different degrees of resistance to commonly used antibiotics and carries a variety of resistance genes. Antibiotics should be used reasonably in combination with drug sensitivity test and genetic testing results in order to reduce the emergence of multidrug-resistant bacteria.更多还原