军医大学本科生鼻腔定植金黄色葡萄球菌和其他可培养菌群的筛查

目的了解鼻腔金黄色葡萄球菌(SA)和其他可培养共生菌的定植情况,为鼻腔定植条件致病菌特别是SA的感染预防及其医院感染控制措施的制定提供参考依据。方法采集在某院临床医学课程学习的健康军医大学本科生鼻前庭标本,以微生物自动化系统接种于各类细菌培养基进行细菌培养和菌落观察,对分离菌株采用质谱鉴定,对SA进行抗菌药物敏感性试验。结果共采集鼻前庭标本161份,检出鼻腔定植菌549株,其中革兰阳性菌493株,革兰阴性菌56株,居前三位的细菌为拥挤棒状杆菌(151株)、表皮葡萄球菌(150株)、假白喉棒状杆菌(54株)。共有72种不同的带菌模式,以同时检出金黄色葡萄球菌、表皮葡萄球菌和拥挤棒状杆菌带菌模式的学员最多,达21名(13.04%)。鼻腔SA定植率为25.46%(41/161),耐甲氧西林金黄色葡萄球菌(MRSA)定植率为4.35%(7/161),SA菌株对青霉素、红霉素和克林霉素耐药率为39.02%～78.05%。结论军医大学本科生鼻腔定植菌群以正常菌群为主,需注意定植的SA和其他条件致病菌导致自身感染和引发医院感染的可能性。

Screening for nasal colonized Staphylococcus aureus and other cultivable bacteria in students from military medical university

Objective To understand the colonization of Staphylococcus aureus (SA) and other cultivable symbiotic bacteria in nasal cavity, and provide reference for the formulation of prevention and control measures of infection and healthcare-associated infection (HAI) caused by opportunistic pathogenic bacteria (especially SA) colonized in nasal cavity. Methods Nasal vestibule specimens from military medical university healthy students who studied clinical medicine course in a hospital were collected and inoculated on various kinds of bacterial culture media by microbial automation system for bacterial culture and colony observation, the isolated strains were identified by mass spectrometry, SA was performed antimicrobial susceptibility testing. Results A total of 161 nasal vestibular specimens were collected, 549 bacterial strains of nasal colonization were isolated, including 493 strains of gram-positive and 56 strains of gram-negative bacteria, the top three bacteria were Corynebacterium accolens (151 strains), Staphylococcus epidermidis (150 strains) and Corynebacterium pseudodiphtheriticum (54 strains).There were 72 kinds of bacteria carrying patterns, 21 (13.04%) students were detected Staphylococcus aureus, Staphylococcus epidermidis and Corynebacterium accolens simultaneously, which was the most common patterns. Colonization rates of nasal SA and methicillin-resistant Staphylococcus aureus were 25.46% (41/161) and 4.35% (7/161) respectively, resistance rates of SA to penicillin, erythromycin and clindamycin were 39.02%-78.05%. Conclusion Nasal colonized bacteria in these university students are mainly normal flora, it is necessary to pay attention to the possibility of self-infection and HAI caused by colonized SA and other opportunistic pathogens.