我国医院中社区获得性耐甲氧西林金黄色葡萄球菌流行情况的Meta分析

朱怡青; 陈保立; 毕振旺; 寇增强; 胡彬; 房明; 毕振强

Abstract

朱怡青,陈保立,毕振旺,寇增强,胡彬,房明,毕振强.我国医院中社区获得性耐甲氧西林金黄色葡萄球菌流行情况的Meta分析[J].Chinese journal of Epidemiology,2016,37(2):273-280

我国医院中社区获得性耐甲氧西林金黄色葡萄球菌流行情况的Meta分析

Meta-analysis on epidemiology of iatrogenic-borne methicillin-resistant Staphylococcus aureus

Received:May 07, 2015

DOI：10.3760/cma.j.issn.0254-6450.2016.02.025

KeyWord: 耐甲氧西林金黄色葡萄球菌社区获得性感染医院感染杀白细胞毒素耐药性

English Key Word: Methicillin-resistant Staphylococcus aureus Community acquired infection Nosocomial infection Panton-valentine leucocidin Drug resistance

FundProject:国家科技重大专项(2012ZX10004210-003);山东省优秀中青年科学家科研奖励基金项目(BS2014SW020)

Author Name	Affiliation	E-mail
Zhu Yiqing	Department of Epidemiology and Biostatistics, Shandong University, Jinan 250012, China
Chen Baoli	Institute of Bacterial Infections Disease Control, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China
Bi Zhenwang	Institute of Bacterial Infections Disease Control, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China
Kou Zengqiang	Institute of Bacterial Infections Disease Control, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China
Hu Bin	Institute of Bacterial Infections Disease Control, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China
Fang Ming	Institute of Bacterial Infections Disease Control, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China
Bi Zhenqiang	Department of Epidemiology and Biostatistics, Shandong University, Jinan 250012, China Institute of Bacterial Infections Disease Control, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China Shandong Key Laboratory of Infectious Disease Prevention and Control, Institute of Preventive Medicine, Shandong University Jinan 250012, China	bzq63@163.com

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Abstract:

目的通过Meta分析了解我国医院发现的社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)的分子生物学特征和流行病学现状。方法系统检索2015年12月3日前收录于中国知网(CNKI)、万方数据库、PubMed和Web of Science核心合集的期刊或学位论文,遵照PRISMA规范进行Meta分析,利用Stata 13.0软件对医院发现的CA-MRSA检出率、杀白细胞素基因(PVL)基因携带率等数据进行合并,对医院和社区的CA-MRSA检出率进行比较。结果医院患者中检出的CA-MRSA占金黄色葡萄球菌的12%(95% CI:8%~16%);占MRSA的18%(95% CI:12%~24%);CA-MRSA中PVL携带率约为42.1%(95% CI:20.4%~63.7%),高于一般的MRSA(t=-2.99,P=0.011)。结论我国医院中CA-MRSA检出率较低,但PVL基因携带率高。需采取有效监测和预防措施,以达到控制CA-MRSA在人群中传播的目的。

English Abstract:

Objective To study the molecular-biologic characteristics and epidemiological status of iatrogenic related Community-acquired methicillin-resistant Staphylococcus(S.) aureus(CA-MRSA) in China through Meta-analysis.Methods Data through systematic searching for peer-reviewed articles published before December 3^rd, 2015 from 4 main electronic databases including China National Knowledge Infrastructure(CNKI), Wanfang Data, PubMed and Web of Science Core Collection was collected, for this Meta-analysis.PRISMA guidelines were followed and the proportion of MRSA, CA-MRSA, hospital-acquired MRSA(HA-MRSA) and panton-valentine leucocidin(PVL) gene in certain populations were quantitatively analyzed by Stata 13.0 software.Results Average proportion of CA-MRSA from S.aureus was 12%(95% CI:8%-16%).CA-MRSA in MRSA was 18%(95% CI:12%-24%).42.1%(95% CI:20.4%-63.7%) of the CA-MRSA carried a PVL gene, and the number was higher than general MRSA(t=-2.99, P=0.011).Conclusion CA-MRSA was in lower proportion than HA-MRSA, both seen in general MRSA and in S.aureus, but under higher proportion of carrying the PVL gene.Transmission of CA-MRSA could be prevented within the general population through conducting effective surveillances and preventive programs.

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