金黄色葡萄球菌临床株对利奈唑胺耐药性及耐药机制

发布时间：2019-07-16 17:29

【摘要】：目的了解金黄色葡萄球菌(金葡菌)临床株对利奈唑胺耐药性及耐药机制。方法收集2011-2014年浙江省人民医院900株金葡菌,采用纸片扩散法测定利奈唑胺药敏,对筛选到的耐药菌株采用琼脂稀释法测定常用药物的最低抑菌浓度(MIC),同时对其耐药基因cfr、optr A、23S r RNA基因第5功能区进行PCR扩增和序列分析。对cfr或optr A基因阳性的菌株进行基因周围序列分析和菌株多位点序列分型(MLST)。结果临床分离金葡菌对利奈唑胺耐药率为0.1%(1/900),仅发现1株耐药株,该菌株为耐甲氧西林金葡菌(MRSA),对利奈唑胺MIC为8 mg/L、头孢西丁48 mg/L、青霉素32 mg/L、环丙沙星128 mg/L、克林霉素32 mg/L、氯霉素128 mg/L、万古霉素0.75 mg/L、替考拉宁0.5 mg/L。除万古霉素和替考拉宁,对其他抗菌药物均耐药。PCR结果显示该菌株cfr基因为阳性,optr A阴性,无23S rRNA突变。该菌株携带的cfr基因位于"Tn4001-like转座子-cfr-orf1-ISEnfa4"复合转座子中,并定位于一个39 504 bp的质粒上。该菌株的MLST分型为ST5。结论临床分离金葡菌对利奈唑胺耐药率低,发现1株cfr基因介导的利奈唑胺耐药株,cfr基因位于质粒上一个常见的复合转座子中。
[Abstract]:Objective To study the resistance and mechanism of the clinical isolates of Staphylococcus aureus (Staphylococcus aureus) on the drug-resistant and drug-resistant of leinamide. Methods 900 strains of staphylococcus aureus were collected from the People's Hospital of Zhejiang Province from 2011 to 2014, and the drug sensitivity of the method was determined by the method of paper-paper diffusion. The minimum inhibitory concentration (MIC) of the common drugs was determined by the agar dilution method, and the drug-resistant genes, cfr, optrA, were determined. The PCR amplification and sequence analysis were performed on the fifth functional area of the 23S r RNA gene. The gene-positive strains of the cfr or optrA gene were subjected to a gene-specific sequence analysis and a strain multi-site sequence classification (MLST). Results The drug-resistant rate of the clinical isolates of Staphylococcus aureus was 0.1% (1/900), and only one drug-resistant strain was found. The strain was methicillin-resistant Staphylococcus aureus (MRSA). The MIC was 8 mg/ L, cefoxitin 48 mg/ L, penicillin 32 mg/ L, ciprofloxacin 128 mg/ L, clindamycin 32 mg/ L, and chloramphenicol 128 mg/ L. Vancomycin 0.75 mg/ L, teicoplanin 0.5 mg/ L. All other antimicrobial agents were resistant to vancomycin and teicoplanin. The results showed that the cr gene of the strain was positive, and the optrA was negative and no 23S rRNA mutation. The cfr gene carried by the strain is located in a "Tn4001-like Transposon-cfr-orf1-ISEnfa4" complex transposon and is positioned on a 39 504 bp plasmid. The MLST of the strain is ST5. Conclusion The resistance rate of the clinical isolates of staphylococcus aureus is low, and 1 strain of the cfr gene is found to be a common compound transposon in the plasmid.
【作者单位】：浙江工业大学;浙江大学医学院附属第二医院检验科;浙江省人民医院检验科;
【基金】：浙江省医药卫生科技项目(2015112173) 浙江省自然科学基金(LQ13H200001)
【分类号】：R446.5

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