患儿感染耐甲氧西林凝固酶阴性葡萄球菌耐药性及基因分型研究

发布时间：2018-05-08 22:35

  本文选题：感染耐甲氧西林凝固酶阴性葡萄球菌 + 耐药性　； 参考：《中华医院感染学杂志》2017年23期

【摘要】：目的调查研究患儿感染耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)耐药性及基因分型,为MRCNS感染的抗菌药物选择、NRCNS感染的防治提供科学参考依据。方法收集2011年1月-2016年12月期间儿科164例感染性疾病患儿送检的164份临床标本,行菌株培养、表型筛选;采用标准琼脂倍比稀释法对MRCNS进行抗菌药物最低抑菌浓度(MIC)检测,确定耐药状况;采用聚合酶链反应(PCR)扩增基因检测葡萄球菌染色体mec基因盒(SCCmec)各分型。结果 164份标本中共检出78株MRCNS,检出率为47.56%;其中耐甲氧西林表皮葡萄球菌(MRSE)35株占44.87%,耐甲氧西林溶血性葡萄球菌(MRSH)19株占24.36%,耐甲氧西林人葡萄球菌(MRSHo)10株占12.82%;MRCNS对青霉素、头孢哌酮、头孢曲松、头孢噻肟、亚胺培南均完全耐药,耐药率为100.00%,对红霉素、阿奇霉素、克林霉素的耐药率均80.00%,对万古霉素完全敏感,耐药率为0;MRCNS的SCCmec基因分型Ⅰ~Ⅵ型有检出,Ⅶ~Ⅷ型未检出,其中Ⅲ型基因38株占48.72%,混合型19株占24.36%,7株IV型占8.97%。结论患儿感染性疾病时MRCNS检出率较高,MRCNS对临床常用的多种抗菌药物耐药率高,具有多药耐药性,MRCNS所携带的SCCmec基因型主要为Ⅲ型及混合型,以上基因可能与MRCNS耐药关系密切。
[Abstract]:Objective to investigate the drug resistance and genotyping of methicillin-resistant coagulase-negative staphylococci (MRCNS) in children with MRCNS infection and to provide a scientific basis for the prevention and treatment of MRCNS infection. Methods from January 2011 to December 2016, 164 clinical specimens from 164 pediatric children with infectious diseases were collected for strain culture and phenotypic screening, and the minimal inhibitory concentration (MIC) of antimicrobial agents in MRCNS was detected by standard Agar doubling dilution method. The status of drug resistance was determined and the genotypes of staphylococcal chromosome mec gene box were detected by polymerase chain reaction (PCR) amplification. Results A total of 78 MRCNSs were detected in 164 specimens, and the detection rate was 47.56.The MRSE-resistant Staphylococcus epidermidis (MRSE-35) accounted for 44.87, the methicillin-resistant Staphylococcus haemolyticus was 24.3636, the methicillin resistant MRSHo10 was 12.822 MRCNS for penicillin, cefoperazone. Ceftriaxone, cefotaxime, imipenem were all completely resistant, and the resistance rate was 100.000.The resistance rates to erythromycin, azithromycin and clindamycin were 80.00and were completely sensitive to vancomycin. Type 鈪，

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