Drug resistance and risk factors of Staphylococcus aureus in skin and soft tissue infections

doi:10.11958/20253187

Abstract

Abstract:

Objective To explore the pathogenic characteristics and drug resistance of Staphylococcus aureus (SA) in patients with skin and soft tissue infections (SSTIs), and to analyze the risk factors for methicillin-resistant Staphylococcus aureus (MRSA) infection. Methods A total of 110 patients who were hospitalized due to SSTIs and whose secretions or drainage fluid were cultured as SA were selected. The clinical data of the patients were collected, and the status of patients with SA infection, the antibiotics sensitivity of the SA strains and the carrying rate of drug-resistant genes were statistically analyzed. Multivariate Logistic regression was used to analyze the influencing factors of MRSA infection in SSTIs patients. Results A total of 110 SSTIs-related SA isolates were isolated, among which 27 isolates (24.5%) were MRSA. Compared with the methicillin-sensitive Staphylococcus aureus (MSSA) group, the MRSA group had a higher proportion of outpatient antibiotic treatment before admission and mecA gene carriage rate (P<0.05). The resistance rate of SA to penicillin was the highest (94.5%), followed by erythromycin (58.2%), and the resistance rate to rifampicin was the lowest (0.9%). Resistance to linezolid, tigecycline, vancomycin, daptomycin and teicoplanin was not observed. Compared with the MSSA group, the MRSA group had a higher resistance rate to oxacillin, tetracycline, minocycline and levofloxacin (P<0.05). Logistic regression analysis showed that outpatient antibiotic treatment before admission and fever were risk factors for MRSA infection in SSTIs patients (P<0.05). Conclusion The drug resistance spectrum of SA in SSTIs is different, and MRSA strains show extensive multi-drug resistance. SSTIs patients with outpatient antibiotic treatment and fever before admission are more likely to have MRSA infection.

Key words: Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, anti-bacterial agents, skin and soft tissue infections, drug resistance, risk factors

CLC Number:

R978.1

Figures/Tables 6

References 28

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基因名称	引物序列（5′→3′）	产物大小/bp
mecA	上游：AAAATCGATGGTAAAGGTTGGC 下游：AGTTCTGCAGTACCGGATTTGC	532
aph（3'）-Ⅲa	上游：CCGCTGCGTAAAAGATAC 下游：GTCATACCACTTGTCCGC	609
aac（A）-aph（D）	上游：CAGAGCCTTGGGAAGATGAAG 下游：CCTCGTGTAATTCATGTTCTGGC	348

基因名称	引物序列（5′→3′）	产物大小/bp
mecA	上游：AAAATCGATGGTAAAGGTTGGC 下游：AGTTCTGCAGTACCGGATTTGC	532
aph（3'）-Ⅲa	上游：CCGCTGCGTAAAAGATAC 下游：GTCATACCACTTGTCCGC	609
aac（A）-aph（D）	上游：CAGAGCCTTGGGAAGATGAAG 下游：CCTCGTGTAATTCATGTTCTGGC	348

组别		n	性别		年龄			菌株分离部位
组别		n	男	女	≤65岁		>65岁	足部	头颈部	上肢	下肢	其他
MSSA组		83	56（67.5）	27（32.5）	48（57.8）		35（42.2）	59（71.1）	7（8.4）	6（7.2）	5（6.0）	6（7.2）
MRSA组		27	22（81.5）	5（18.5）	14（51.9）		13（48.1）	22（81.5）	3（11.1）	1（3.7）	1（3.7）	0（0.0）
χ²			1.939		0.296			1.134	0.001	0.039	0.000	0.901
组别	合并症					入院前抗生素治疗史			临床表现
组别	糖尿病		高血压	慢性肾脏病	癌症	无	门诊	其他医疗机构住院	发热	水肿	流脓	疼痛
MSSA组	68（81.9）		67（80.7）	11（13.3）	5（6.0）	53（63.9）	13（15.7）	17（20.5）	8（9.6）	80（96.4）	48（57.8）	68（81.9）
MRSA组	24（88.9）		19（70.4）	2（7.4）	2（7.4）	14（51.9）	9（33.3）	4（14.8）	7（25.9）	26（96.3）	15（55.6）	20（74.1）
χ²或P	0.302		1.568	0.225	0.000	1.223	3.976^＊	0.424	3.310	1.000^▲	0.043	0.785

组别		n	性别		年龄			菌株分离部位
组别		n	男	女	≤65岁		>65岁	足部	头颈部	上肢	下肢	其他
MSSA组		83	56（67.5）	27（32.5）	48（57.8）		35（42.2）	59（71.1）	7（8.4）	6（7.2）	5（6.0）	6（7.2）
MRSA组		27	22（81.5）	5（18.5）	14（51.9）		13（48.1）	22（81.5）	3（11.1）	1（3.7）	1（3.7）	0（0.0）
χ²			1.939		0.296			1.134	0.001	0.039	0.000	0.901
组别	合并症					入院前抗生素治疗史			临床表现
组别	糖尿病		高血压	慢性肾脏病	癌症	无	门诊	其他医疗机构住院	发热	水肿	流脓	疼痛
MSSA组	68（81.9）		67（80.7）	11（13.3）	5（6.0）	53（63.9）	13（15.7）	17（20.5）	8（9.6）	80（96.4）	48（57.8）	68（81.9）
MRSA组	24（88.9）		19（70.4）	2（7.4）	2（7.4）	14（51.9）	9（33.3）	4（14.8）	7（25.9）	26（96.3）	15（55.6）	20（74.1）
χ²或P	0.302		1.568	0.225	0.000	1.223	3.976^＊	0.424	3.310	1.000^▲	0.043	0.785

组别	n		青霉素		苯唑西林	庆大霉素		四环素		米诺环素		红霉素
MSSA组	83		77（92.8）		0（0.0）	14（16.9）		9（10.8）		1（1.2）		48（57.8）
MRSA组	27		27（100.0）		27（100.0）	4（14.8）		8（29.6）		5（18.5）		16（59.3）
χ²			0.901		110.000^＊＊	0.000		4.159^＊		8.723^＊＊		0.017
组别		克林霉素		环丙沙星			左氧氟沙星		利福平		甲氧苄啶-磺胺甲噁唑
MSSA组		22（26.5）		8（9.6）			5（6.0）		0（0.0）		27（32.5）
MRSA组		10（37.0）		7（25.9）			6（22.2）		1（3.7）		6（22.2）
χ²或P		1.095		3.310			4.276^＊		0.245^▲		1.031