目的：评价实时荧光定量聚合酶链反应（PCR）在快速检测耐甲氧西林金黄色葡萄球菌（MRSA）中的临床应用价值。方法经培养鉴定的70例已知细菌中22例为 MRSA，48例为非 MRSA，对已知细菌用实时荧光定量 PCR 进行检测，了解该方法的特异性和敏感性。对临床88例医护人员和患者的鼻拭子进行实时荧光定量PCR 检测，了解医院内 MRSA 的携带情况。结果培养为 MRSA，实时荧光定量 PCR 检测结果均为 MRSA，敏感性为100％；培养为非 MRSA，实时荧光定量 PCR 检测结果均为非 MRSA，特异性为100％。实时荧光定量 PCR检测 MRSA 的敏感性可确定为1×103 cfu/mL。48例患者的鼻拭子 mecA 耐药基因阳性26例，金黄色葡萄球菌阳性28例，两者同时阳性（即为 MRSA）20例，MRSA 阳性检出率为41．6％；40例医护人员鼻拭子 mecA 耐药基因阳性12例，金黄色葡萄球菌阳性13例，两者同时阳性（即为 MRSA）9例，MRSA 阳性检出率为22．5％。结论实时荧光定量 PCR 可用于临床对 MRSA 的快速检测。%Objective To evaluate the clinical application significance of real-time fluorescence quantitation polymerase chain reaction (PCR) in rapid determination of methicillin-resistant Staphylococcus aureus (MRSA). Methods Among 70 cultured and identified samples of known bacteria,22 samples were MRSA,48 samples were not. In order to find out the specificity and sensitivity of the method,the known bacteria were determined by real-time fluorescence quantitation PCR.In order to detect the carrying condition of nosocomial MRSA,the nasal swabs of 88 clinical medical staff and patients were determined by real-time fluorescence quantitation PCR.Results All of the cultured MRSA determined by real-time fluorescence quantitation PCR were MRSA,and the sensitivity was 100%.All of the cultured non-MRSA determined by real-time fluorescence quantitation PCR were not MRSA either,and the specificity was 100%.The sensitivity of determining MRSA by real-time fluorescence quantitation PCR can be confirmed as 1 ×103 cfu/mL.Among 48 nasal swabs of patients,26 samples were mecA gene positive,28 samples were Staphylococcus aureus positive,20 samples were both positive simultaneously (which were MRSA),and the positive rate of MRSA was 41.6%.Among 40 nasal swabs of clinical medical staff,12 samples were mecA gene positive,13 samples were Staphylococcus aureus positive,9 samples were both positive simultaneously (which were MRSA),and the positive rate of MRSA was 22.5%.Conclusions Real-time fluorescence quantitation PCR can be used for the rapid determination of MRSA.
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