中山地区耐甲氧西林金黄色葡萄球菌的耐药性分析及基因分型研究

发布时间：2018-01-05 09:16

本文关键词：中山地区耐甲氧西林金黄色葡萄球菌的耐药性分析及基因分型研究　出处：《现代预防医学》2016年19期 　论文类型：期刊论文

【摘要】：目的了解中山地区耐甲氧西林金黄色葡萄球菌(MRSA)临床分离株耐药性及基因型,为MRSA治疗及感染控制提供数据及分子生物学支持。方法收集2015年1月至2015年10月中山市7家医院临床分离到的MRSA,采用WOHONET 5.6对耐药数据进行统计分析,PCR检测MRSA耐药基因mec A携带情况,采用多重PCR对分离株进行葡萄球菌染色体mec基因盒(SCCmec)分型。结果 2015年1月至2015年10月7家医院共分离到50株MRSA,所有MRSA分离株均检出mec A基因,检出率为100%。SCCmec各分型数量依次为I型1株(2%),II型2株(4%),III型28株(56%),IV型6株(12%),V型12株(24%),有1株不能分型。中山市古镇人民医院分离MRSA株主要为SCCmec III型,其他6家医院主要为SCCmec IV型及V型。MRSA对青霉素耐药率为100%,对红霉素(90%)、庆大霉素(86%)、左氧氟沙星(84%)、诺氟沙星(84%)、克林霉素(76%)耐药率较高,对奎奴普丁/达福普丁(4%)耐药率较低,未检出替考拉宁及万古霉素耐药株。SCCmec III型菌株对庆大霉素、利福平、左氧氟沙星、诺氟沙星、复方新诺明、克林霉素、红霉素、奎奴普丁/达福普丁及四环素耐药率高于SCCmec V型菌株。结论 mec A是MRSA携带最常见的耐药基因,中山地区分离MRSA株在规模较大的医院主要以SCCmec III型为主,基层医院以SCCmec IV及V型为主,SCCmec III型对常用抗菌药敏感性较差,耐药机制较为复杂,临床科室及医院感染控制部门应重点监控该型细菌,避免院内感染暴发。
[Abstract]:Objective to investigate the methicillin resistant Staphylococcus aureus in Zhongshan (MRSA) clinical isolates of resistance and genotypes, MRSA treatment and infection control data and molecular biology. Methods from January 2015 to October 2015 in Zhongshan City, the 7 hospital clinical isolates of MRSA, WOHONET 5.6 was used for statistical analysis of resistance data, carrying case PCR detection of MRSA resistance gene MEC A, using multiple PCR staphylococcal cassette chromosome mec of isolates (SCCmec) typing. Results from January 2015 to October 2015 7 hospitals were isolated from 50 strains of MRSA, MRSA strains were detected by MEC A gene, the detection rate was 100%.SCCmec the number of each type of order I 1 strains (2%), 2 strains of II (4%), 28 strains of III (56%), 6 strains of IV (12%), 12 strains of V (24%), 1 strains cannot be classified. The ancient town of Zhongshan City People's Hospital for SCCmec separation of MRSA strain of type III, the other 6 hospitals Mainly for SCCmec IV and V.MRSA to penicillin was 100% to erythromycin, gentamicin (90%), (86%), levofloxacin (84%), norfloxacin (84%), clindamycin (76%) drug resistance rate is higher, the Que Manu F Martin / Dafoe Putin (4%) low resistance rate, no detection of teicoplanin and vancomycin resistant strains of.SCCmec type III strain of gentamicin, rifampicin, levofloxacin, norfloxacin, cotrimoxazole, erythromycin, clindamycin, quinupristin / Dafoe Putin and tetracycline resistance was higher than that of the SCCmec strain of V. Conclusion MEC A is the most common MRSA carrying resistance genes, MRSA strains isolated in Zhongshan in large scale hospital with SCCmec type III, SCCmec IV and V in primary hospital type, SCCmec III type of antimicrobial sensitivity is poor, resistance mechanism is complex, clinical departments and hospital infection control departments should focus on monitoring the fine Bacteria, avoid outbreaks of nosocomial infection.

【作者单位】：中山市古镇人民院检验科;
【基金】：中山市科技计划项目,项目编号:2014A1FC058
【分类号】：R440
【正文快照】： 金黄色葡萄球菌是引起医院及社区感染最常见的病原菌之一,可引起皮肤软组织、手术切口及伤口感染,也可引起肺炎、脑膜炎甚至威胁患者生命的血流感染,是临床分离革兰阳性菌中最常见的病原菌[1-3]。随着广谱抗菌药物在临床的广泛使用,导致耐甲氧西林金黄色葡萄球菌(MRSA)在临床

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