Community-genotype strains of methicillin-resistant Staphylococcus aureus with high-level mupirocin resistance in a neonatal intensive care unit

Aim

The aim of this study was to investigate the genotypes of mupirocin-resistant methicillin-resistant Staphylococcus aureus (MR-MRSA) isolates in our neonatal intensive care unit (NICU) and their potential source.

Study design

One hundred one MRSA isolates obtained from 59 inborn and 42 outborn infants were identified and their antimicrobial susceptibility determined. Using pulse-field gel electrophoresis (PFGE) analysis, MR-MRSA isolates obtained from the neonatal patients in the NICU were compared with those from adult hospitalized in the same hospital and with community-associated MRSA (CA-MRSA) isolates recovered from different hospitals in Korea.

Results

Overall, 47% of CA-MRSA and 79% of healthcare-associated MRSA isolates exhibited high-level mupirocin resistance (HLMR). Forty-five percent of the outborn infants were considered to have CA-MRSA at the time of admission to our NICU. Most HLMR-MRSA isolates from neonates were grouped into a single cluster by PFGE analysis, and which included CA-MRSA isolates with HLMR recovered from outborn infants who were already colonized when they were transferred to our NICU. They belonged to the same PFGE group as the community-genotype strains isolated from different hospitals in Korea. HLMR-MRSA isolates from adults patients were classified as different clones. None of the attending staff in the NICU were nasal carriers.

Conclusion

Community-genotype strains of MRSA with HLMR may be imported to our NICU through obstetrics clinics and contribute to MRSA colonization or infection in facilities with a high rate of admission of outborn infants.     

北京地区青霉素不敏感肺炎链球菌分子流行病学的初步探讨

目的了解北京地区儿童中青霉素不敏感肺炎链球菌（PNSP）的流行状况,阐明其分子流行病学特征。方法以2000-2002年于0～5岁上呼吸道感染儿童鼻咽部分离的63株PNSP冻存标本为研究对象,进行耐药模式分析,以聚合酶链反应（PCR）扩增青霉素结合蛋白（PBP）基因pbpla、pbp2b和pbp2x,分析其限制性片段长度多态性（RFLP）,并进行细菌染色体RFLP脉冲场凝胶电泳（PFGE）比较。结果63株PNSP有61株（96．8％）为多重耐药菌株。pbpla、pbp2b和pbp2x分别有8、9和18种基因型,三者组合的谱型共有30种。63株PNSP的PFGE型共分为35个,其中,9种PFGE型包括菌株≥2株,这9种型共包含37株,占59％,均为多重耐药菌株。与亚洲流行菌株比较,我们发现2株PFGE型可能相关的PNSP分别与亚洲流行菌株越南-19群、新加坡-19群、中国台湾-19群和韩国-19群谱型完全相同。结论北京地区儿童中PNSP的多重耐药状况严峻,克隆传播是PNSP流行的重要因素;已存在与亚洲流行菌株相同的克隆,值得关注。     

儿童肺炎链球菌耐药性与pbp2b基因RFLP和PFGE图型分析

目的　监测肺炎链球菌对青霉素和其他抗生素的耐药情况 ;分析pbp2b基因扩增产物图谱与青霉素耐药性的相关性 ;对 3 1株青霉素耐药菌株进行血清分型 ;分析血清型 2 3F和血清型 6的青霉素耐药菌株的脉冲电场凝胶电泳 (PFGE)图型 ,初步了解北京地区耐药菌株分子流行病学上的特点。方法　 ( 1)抗生素药物敏感试验 ;( 2 )用聚合酶链反应 (PCR)和限制性内切酶片段长度多态性分析 (RFLP)方法 ,分析pbp2b基因扩增产物图谱与青霉素耐药性的相关性 ;( 3 )使用乳胶凝集的方法 ,对 3 1株青霉素耐药菌株进行血清分型 ;( 4 )使用PFGE图型方法分析 6株血清型 2 3F和 3株血清型 6的青霉素耐药菌株流行病学上的基本特性。结果　 ( 1)对青霉素的耐药性由 1997年 9 9%上升到 2 0 0 0年 14 6% (P >0 0 5)。对红霉素、复方磺胺甲基异唑和氯霉素耐药性分别由 1997年76 8%、74 7%和 2 2 6%上升到 2 0 0 0年的 87 4%、88 3 %和 40 8% (P <0 0 5) ;( 2 )通过PCR和RFLP方法分析青霉素耐药菌株和青霉素敏感菌株表明 ,pbp2b基因扩增图谱与青霉素耐药性之间有较好的相关性 ;( 3 )对 3 1株青霉素不敏感肺炎链球菌 (PRSP)做了血清型 2 3F和 6分型。前者为 6株 ( 19% ) ;后者为 3株 ( 9% )。 6株血清型 2 3F肺炎链球菌均为低水平     

Spread of methicillin‐resistant Staphylococcus aureus USA300 in a neonatal intensive care unit

Background: Reports of community‐associated methicillin‐resistant Staphylococcus aureus (CA‐MRSA) in neonatal intensive care units (NICU) and in otherwise healthy patients without obvious risk factors have been increasing in frequency. Described herein is a cluster of cases of CA‐MRSA USA300 strains in an NICU affecting infants, health‐care workers and the health‐care workers’ families. Methods: Infants and health‐care workers with infection and colonization due to MRSA between 1 January 2004 and 30 June 2005 in a tertiary care center NICU in San Antonio, TX were studied. Antimicrobial susceptibility testing and polymerase chain reaction detection of the mecA gene characterized the MRSA isolates. All MRSA cases were reviewed for clinical severity of infection and outcome. Results: During the 18 months studied, a total of four (0.6%) of 676 infants had CA‐MRSA bacteremia or colonization. One infant with necrotizing pneumonia died and three health‐care workers who directly cared for the infected infants developed soft‐tissue infections caused by CA‐MRSA. Four family members of two health‐care workers subsequently developed soft‐tissue infections. All of the analyzed isolates (eight of nine) belonged to pulsed‐field type USA300 and possessed Panton–Valentine leukocidin genes, which have been associated with severe skin and soft‐tissue infections, and necrotizing pneumonia. Conclusions: It is likely that the CA‐MRSA USA300 strain can be transmitted between NICU patients to health‐care workers and their family members. The CA‐MRSA cases reported here reinforce the virulence of CA‐MRSA USA300 strains and emphasize the need to embrace infection control practices designed to protect hospitalized patients, health‐care workers and their family members.     

Colistimethate sodium therapy for multidrug‐resistant isolates in pediatric patients

Aim: The aim of the present study was to assess the efficacy and safety of colistimethate sodium therapy in multidrug‐resistant nosocomial infections caused by Pseudomonas aeruginosa or Acinetobacter baumannii in neonates and children. Methods: Pediatric patients hospitalized at the Uludag University Hospital who had nosocomial infections caused by multidrug‐resistant P. aeruginosa or A. baumannii, were enrolled in the study. Colistimethate sodium at a dosage of 50–75 × 10³ U/kg per day was given i.v. divided into three doses. Results: Fifteen patients received 17 courses of colistimethate sodium for the following infections: ventilator‐associated pneumonia (n= 14), catheter‐related sepsis (n= 1) and skin and soft‐tissue infection (n= 2). The mean age of patients was 53.2 + 74.7 months (range, 8 days–15 years) and 60% were male. Mortality was 26.6%. Conclusion: Colistimethate sodium appears to be safe and effective for the treatment of severe infections caused by multidrug‐resistant P. aeruginosa or A. baumannii in pediatric patients.     

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??Abstract??Objective To investigate the molecular epidemiology of Escherichia coli isolated from neonates in Bejing Children’s Hospital. Methods Pulsed field gel electrophoresis??PFGE?? typing was conducted for 110 strains of Escherichia coli clinical isolates from 102 neonates hospitalized at the Neonatal Center of Beijing Children's Hospital from September 2009 to May 2012. Results Totally 110 strains of Escherichia coli isolated by PFGE typing were divided into 65 types??the similarity coefficient between 47.3%??100%.Dominant gene type contained 13 stains??similarity coefficient between 80.4%??100%. There were 8 pairs of clinical isolates strains from the same neonatal patient??7 pairs of which were confirmed by PFGE typing methods that they belonged to the same type??1 of which isolated from the same neonatal patient with cerebrospinal fluid and blood??belonging to the same genotype??the similarity coefficient being 93.8%??. The other 1 pair of strains?? typed by PFGE method?? showed that they were not the same type and were distantly related. It meant that they were different strains infection or contamination. Five of strains by PFGE typing confirmed that genetic relationship was close??and 1 of them had ever shared the same ward with the other 4 strains. Conclusion PFGE technique is accurate and reliable??PFGE study is helpful for clinicians to confer and distinguish the pathogenic strains?? and trace the source of infection. It plays an important role in preventing the occurrence of nosocomial infections.     

Risk factors and pathogen profile of ventilator‐associated pneumonia in a neonatal intensive care unit in China

Background: The aim of the present study was to explore the incidence and risk factors of, and summarize the involved pathogens in, neonates with ventilator‐associated pneumonia (VAP) in the authors' neonatal intensive care unit (NICU) to determine the effective strategies for prevention. Methods: A retrospective case–control study including 117 VAP patients and 232 controls was conducted from January 2002 to July 2008. The antibiotics sensitivity spectrum was determined on quantitative microbiological evaluation. Multiple logistic regression and Cox model analysis were performed to determine independent and accumulative risk factors for VAP. Results: Multivariate analysis showed that birthweight, mechanical ventilation (MV), parenteral alimentation, dexamethasone and other respiratory disease were associated with the development of VAP. The cumulative risk for developing VAP increased over the duration of stay in the NICU. The most common isolated bacteria of the pathogen spectrum in VAP were Klebsiella spp. (33/146), Acinetobacter baumannii (26/146), Pseudomonas aeruginosa (18/146) and Staphylococcus aureus(13/146). Meanwhile, we found that previous use of antibiotics before VAP diagnosis was not associated with the onset of VAP. Conclusions: The daily risk for VAP increases with duration of stay in the NICU after ventilation. Drug‐resistant bacteria are common pathogens for neonatal VAP in the authors' NICU.     

儿科患者分离鲍曼不动杆菌耐药性及分子流行病学研究

目的分析儿科患者分离出的鲍曼不动杆菌的耐药性及分子流行病学特征。方法以2016年1月至2018年6月内蒙古医科大学附属医院住院患者分离的医院感染鲍曼不动杆菌作为研究对象,采用Vitek-2 Compact全自动微生物鉴定及药敏分析系统进行鉴定及药敏试验,采用脉冲场凝胶电泳(PFGE)方法及多位点序列分型(MLST)进行菌株同源性分析。结果共收集鲍曼不动杆菌临床分离株94株,其中42株来自儿科患者,52株来自成人患者。儿科分离株对亚胺培南、美罗培南和替加环素耐药率分别为7.1%、7.1%和0,成人分离株对这3种抗生素耐药率分别为67.3%、54.8%和5.5%。PFGE分型结果显示,94株菌共分为49个基因型(X1~X49型),52株成人分离株分布于22个基因型,42株儿童分离株分布于33个基因型中。优势基因型为X23型(21株,22.3%),其中成人分离株为18株(85.7%),儿童分离株为3株(14.3%)。X23基因型菌株对碳青霉烯类耐药率为100%,明显高于其他基因型菌株。MLST分型结果显示,X23基因型为ST195,归属于克隆复合体92(CC92)克隆群。结论内蒙古医科大学附属医院鲍曼不动杆菌儿童分离株总体耐药率明显低于成人分离株,基因型多样化特征明显,优势基因型归属CC92克隆群,为我国多地分离优势克隆株。     

住院新生儿大肠杆菌分离株脉冲电场凝胶电泳分型

摘要： 目的 通过对新生儿临床分离的大肠杆菌菌株进行分型以示大肠杆菌菌株间的异质性和亲缘性,了解大肠杆菌感染的分子流行病学特征。方法 对2009年9月至2012年5月间北京儿童医院新生儿中心住院的102例患儿的110株大肠杆菌进行脉冲场凝胶电泳分型（PFGE）。结果 110株大肠杆菌临床分离株经PFGE共分65型,相似系数在47.3%～100%,条带在13～22条。优势基因型有13株,相似系数在80.4%～100%。有8对临床分离菌株分别来自于同一患儿,其中7对经PFGE分型方法证实它们属于同一型别（其中1对菌株来自于同一患儿的血液及脑脊液的标本,经PFGE分型证实属于同一基因型,相似系数为93.8%）;另1对显示不是同一型别,亲缘关系较远,故从同源性分析来看不除外不同菌株感染或污染的可能。5株菌株经PFGE证实菌株间亲缘关系较近,其中1株分离株来源的患儿曾与4株分离株来源的患儿同住一病房,考虑为院内获得性感染。结论 PFGE分型方法准确、可靠,可以协助临床明确和区分致病株与非致病株,追踪传染源,对于院内感染的防控起到重要的作用。     

Multidrug resistantSalmonella typhi in Delhi

In 1990, we isolated 158 strains ofSalmonella typhi from blood cultures of patients suffering from typhoid fever. Seventy nine (50%) of these isolates were found to be simultaneously resistant to chloramphenicol, ampicillin and cotrimoxazole. These strains were also resistant to streptomycin and tetracycline, but sensitive to gentamicin, amikacin and cephalexin. The minimum inhibitory concentrations of chloramphenicol and trimethoprim for a representative number of these strains were found to be >1024 ug/ ml and >128 ug/ml respectively. Majority of the multidrug resistant (MDR) strains tested against cefotaxime (23/23), ciprofloxacin (38/38) and amoxycillin plus clavulanic acid (23/24) were sensitive to these drugs.     

Analysis of Genomic Diversity among Helicobacter pylori Strains Isolated from Iranian Children by Pulsed Field Gel Electrophoresis

Objective:

Presence of genomic diversity among Helicobacter pylori (H. pylori) strains have been suggested by numerous investigators. Little is known about diversity of H. pylori strains isolated from Iranian children and their association with virulence of the strains. Our purpose was to assess the degree of genomic diversity among H. pylori strains isolated from Iranian-children, on the basis of vacA genotype, cagA status of the strains, sex, age as well as the pathological status of the patients.

Methods:

Genomic DNA from 44 unrelated H. pylori strains isolated during 1997–2009, was examined by pulse-field gel electrophoresis (PFGE). Pathological status of the patients was performed according to the modified Sydney-system and genotype/status of vacA/cagA genes was determined by PCR. PFGE was performed using XbaI restriction-endonuclease and the field inversion-gel electrophoresis system.

Findings:

No significant relationship was observed between the patterns of PFGE and the cagA/vacA status/genotype. Also no relationship was observed between age, sex, and pathological status of the children and the PFGE patterns of their isolates. Similar conclusion was obtained by Total Lab software. However, more relationship was observed between the strains isolated in the close period (1997–2009, 2001–2003, 2005–2007, and 2007–2009) and more difference was observed among those obtained in the distant periods (1997 and 2009).

Conclusion:

H. pylori strains isolated from children in Iran are extremely diverse and this diversity is not related to their virulence characteristics. Occurrence of this extreme diversity may be related to adaptation of H. pylori strains to variable living conditions during transmission between various host individuals.     

Outbreak of Acinetobacter baumannii bacteremia in a neonatal intensive care unit: clinical implications and genotyping analysis

BACKGROUND: Outbreaks of sepsis associated with have been rarely reported in neonatal intensive care units (NICUs). We describe such an outbreak in a NICU, and the results of molecular epidemiologic investigations are presented. MATERIALS AND METHODS: Between August and September 2000, 6 premature infants hospitalized in a pediatric NICU developed sepsis. Three additional cases had infections during November and December. For an environmental culture survey, 94 environmental specimens and hand washings of all 43 health care workers involved in this unit were examined for the presence of this organism. Two genotyping methods, pulsed field gel electrophoresis of genomic DNA digested with I and infrequent restriction site polymerase chain reaction, were used to analyze the 9 bacteremic isolates and any isolates obtained from the environmental survey and the hand washings. Another 3 bacteremic isolates of collected in the same NICU in 1999 were incorporated as controls. RESULTS: The 9 infants were premature and had birth weights of <1,500 g. Before onset of sepsis 9 infants had received total parenteral nutrition, and 8 infants had had central venous catheters and received intrafat emulsion. Five (5.3%) environmental specimens and 10 (23.3%) hand washing specimens were positive for the organism. Except for the strain from Case 9, the results of both genotyping methods were concordant; 11 patterns were identified by infrequent restriction site polymerase chain reaction and 10 patterns by pulsed field gel electrophoresis. One major genotype was demonstrated in the first 6 bacteremic isolates as well as 3 hand washing isolates. The genotypes of the other 3 bacteremic isolates, the 3 control strains, the 5 environmental isolates and 7 other hand washing isolates were distinct from the genotype of outbreak strains. CONCLUSION: An outbreak of bacteremia in a NICU was clearly demonstrated by the molecular epidemiologic investigation and was possibly transmitted via the hands of health care workers.     

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??Abstract??Objective??To explore the characteristics on molecular epidemiology of Mycobacterium tuberculosis isolates in chilidren and to analyse the relationship between drug resistance and genotype. Methods??Totally 150 M.tuberculosis isolated strains were collected from Children's Hospital of Chongqing Medical University and typed by MIRU genotyping.The relationship between genetic type and drug resistance was explored. Results??The 150 strains were divided into 89 distinct MIRU patterns’ and 65 isolates of them were unique. Totally 85 strains were grouped into 24 different MIRU clusters. The MIRU genotype of the largest cluster was 223325173533. Drug resistant M. tuberculosis wasn’t associated with cluster type. Conclusion??223325173533 genotype was perhaps the main epidemic strains for children in Chongqing. Drug-resistance might have no relationship with the clustering genotype.     

儿童感染幽门螺杆菌对克拉霉素耐药情况及耐药机制初步研究

目的了解儿童幽门螺杆菌(Helicobacter pylor,Hp)对克拉霉素的耐药情况,探讨Hp对克拉霉素耐药性与23S rRNA基因突变的关系。方法。108例胃黏膜标本均取自2002年10月-2004年1月在浙江大学医学院附属儿童医院进行胃镜检查的患儿,经分离培养鉴定为Hp菌株后,分别采用E-test法和琼脂稀释法检测克拉霉素的最低抑菌浓度(minimum inhibitory concentration,MIC),确定Hp菌株对克拉霉素的耐药性。提取所有108株Hp基因组DNA进行PCR扩增,用限制性片段长度多态性(restriction fragment length polymorphism,RFLP)检测克拉霉素耐药菌株的点突变。结果Hp菌株对克拉霉素耐药率为14．8％(16／108)。16株耐药菌株23S rRNA V功能区PCR扩增片段RFLP分析,13株被BsaⅠ酶切,提示2144位点存在A→G点突变,3株被BbsⅠ酶切,提示2143位点存在A→G点突变,所有敏感菌株均不能被BsaⅠ和BbsⅠ酶切,提示无23S rRNA基因相应位点的点突变。同时本研究中并未发现突变形式与耐药程度的相关性。结论儿童Hp感染对克拉霉素耐药率较高;23S rRNA基因点突变是Hp对克拉霉素耐药的重要因素。耐药菌株存在A2144G和A2143G突变,以前者为主。     

Comparison of pulsed field gel electrophoresis patterns of Bordetella pertussis isolates from unvaccinated children with severe or mild pertussis

BACKGROUND: The clinical spectrum of pertussis ranges from mild cough illnesses of short duration to typical illness with paroxysmal cough, whooping and posttussive vomiting. We performed comparative genotyping of Bordetella pertussis isolates from children in Germany with severe or mild pertussis. METHODS: Pulsed field gel electrophoresis (PFGE) of genomic DNA, digested with the restriction endonucleases Xba I and Spe I, was used to determine the profiles of strains isolated from 31 unvaccinated children with severe symptoms of pertussis (with hospitalization and/or complications) compared with isolates from 32 matched children with mild symptoms. RESULTS: No significant differences in PFGE patterns were found in B. pertussis strains isolated from children with severe vs. mild illness. CONCLUSIONS: Differences in virulence of circulating B. pertussis strains can be absent or might not correlate with specific PFGE patterns. Other methods should be evaluated to identify differences in virulence.     

Ampicillin‐ and ampicillin/sulbactam‐resistant Escherichia coli infection in a neonatal intensive care unit in Japan

The incidence of ampicillin (ABPC)‐resistant Escherichia coli (E. coli) infection in very low‐birthweight infants has been increasing. The rate of ABPC/sulbactam (ABPC/SBT)‐resistant E. coli in this population, however, is currently unknown. We encountered two cases of severe infection due to resistant E. coli and retrospectively studied the prevalence of ABPC‐ and ABPC/SBT‐resistant E. coli in regular surveillance cultures obtained from all neonatal intensive care unit (NICU) patients between 2000 and 2013. The overall prevalence of ABPC‐resistant E. coli was 39% (47/120), accounting for 63% of cases (32/51) between 2007 and 2013, compared with 22% (15/69) between 2000 and 2006. The prevalence of ABPC/SBT resistance was 17% (20/120), which was similar in both periods (16%, 8/51 vs 17%, 12/69). According to these results, not only ABPC, but also ABPC/SBT‐resistant E. coli must be considered in the NICU.     

Molecular epidemiology of methicillin-resistant Staphylococcus aureus in a pediatric ward

BACKGROUND: Nosocomial infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are one of the most serious problems in pediatric wards. Epidemiological analysis of strains isolated in the ward is essential for infection control. There have been few reports in which a molecular epidemiological study of MRSA was performed in pediatric wards. METHODS: Fifty-six MRSA strains isolated in the pediatric ward of Asahikawa Medical College Hospital between 1995 and 1997 were studied. Fifty-two and four isolates were obtained from 27 patients and from two medical staff members, respectively. Forty-one isolates were regarded as colonizing strains and 15 were causes of infections. Genotypes of the isolates were investigated by pulsed-field gel electrophoresis (PFGE). RESULTS: The PFGE patterns of 56 isolates were classified into nine types: type A, its subtypes, A1 and A2, and types B through to G. Seventeen isolates were type A, 32 were type A1, and one of each type of A2 and B through to G were identified. Fifty of 56 isolates, which were isolated from 24 of 29 cases, belonged to type A or its subtypes. CONCLUSIONS: The predominant strain of MRSA isolates in the pediatric ward was a certain strain that may be originated from the one clone. Cross-infection control therefore is the major procedure in the prevention of MRSA dissemination in the ward.     

NICU‐only versus universal screening for newborn hearing loss: Population audit

Aim: Targeted newborn hearing screening for infants in neonatal intensive care units (NICUs) may be considered when resources preclude universal newborn hearing screening (UNHS). However, process outcomes have not been compared between stand‐alone NICU hearing screening programs and NICU screening within a full UNHS program. Methods: Comparison of two consecutive hearing screening programs delivered under similar conditions in the four NICUs in Victoria, Australia. All NICU infants were eligible for pre‐discharge automated auditory brainstem response (AABR) hearing screening. Capture, referral and diagnostic data were collected for all NICU infants during the NICU‐only (April 2003–February 2005) and subsequent UNHS (April 2005–June 2006) programs. Results: 4704 eligible infants were admitted during the 23‐month NICU‐only period, and 3160 during the 15‐month UNHS period. Double AABR using ALGO 3i equipment was planned for both programs but, due to clinician concern about this high‐risk clinical population, the NICU‐only protocol was amended to single AABR using AccuScreen equipment. Capture rates were 71.1% (NICU‐only) vs. 95.4% (UNHS) (P < 0.001), successful follow‐up rates were 85.8% vs. 96% (P= 0.004), and mean corrected age at the first audiology appointment was 51.5 vs. 40.2 days (P= 0.05). Conclusions: NICU screening offered within a larger UNHS program outperformed the stand‐alone NICU hearing screening program on all measured parameters. Greater resourcing might address shortcomings of the stand‐alone program but would also reduce its potential savings. The high loss to follow‐up also argues against the often‐advocated approach of referring all NICU infants for diagnostic audiologic testing, bypassing hearing screening altogether.     

新生儿重症监护病房新生儿鼻部金黄色葡萄球菌定植和菌株的分子特征

目的 探讨NICU患儿鼻部金黄色葡萄球菌（简称金葡菌）的定植情况及分离株的基因型和毒力特征。 方法 采集NICU患儿的鼻拭子,分离培养金葡菌,采用头孢西丁纸片法和mecA检测鉴定甲氧西林耐药金葡菌（MRSA）或敏感金葡菌（MSSA）;分析所有菌株MLST和spa分型,并对MRSA菌株进行SCCmec分型,采用PCR方法检测pvl和sasX和21种超抗原毒力基因。 结果 从429例鼻拭子标本分离出79株金葡菌,定植率18.4%,其中MRSA 22株（27.8%）。79株金葡菌共检测出17种MLST型和29种spa型,最常见型分别为ST59（31.6%）和t437（22.8%）。22株MRSA最常见的SCCmec型为Ⅳa（81.8%）。ST59-Ⅳa-t437（63.6%）和ST188-t189（15.8%）分别是MRSA、MSSA最常见的流行克隆。最主要的毒力基因型为seb-sek-seq（10.1%）。MRSA株seb、sek、seq和pvl的携带率明显高于MSSA株,而sei携带率明显低于MSSA株。 结论 NICU患儿鼻部金葡菌定植率较高,ST59-Ⅳa-t437和ST188-t189分别是MRSA、MSSA最常见的流行克隆;分离株毒力基因携带率较高,MRSA与MSSA菌株的毒力基因型存在差异。