血液分离利奈唑胺耐药头状葡萄球菌耐药性及相关临床特征分析

发布时间：2018-01-03 11:18

本文关键词：血液分离利奈唑胺耐药头状葡萄球菌耐药性及相关临床特征分析　出处：《中国感染与化疗杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的了解利奈唑胺耐药头状葡萄球菌血流感染的临床及病原菌耐药特点。方法收集利奈唑胺耐药头状葡萄球菌血液分离株,并测定药敏;PCR及测序检测耐药基因cfr及23S rRNA耐药突变;临床分离株用脉冲场凝胶电泳(PFGE)进行同源性分析;病例资料分析。结果从3例患者血标本中分离到5株利奈唑胺耐药头状葡萄球菌;这些临床分离株对苯唑西林、左氧氟沙星、庆大霉素等常用抗菌药物耐药,仅对糖肽类、利福平和甲氧苄啶-磺胺甲唑敏感;5株耐药菌的23S rRNA均存在突变,4株携带cfr基因;PFGE显示5株临床株属同一谱型;3例患者均有留置深静脉导管,2例曾接受利奈唑胺治疗。结论利奈唑胺耐药头状葡萄球菌呈多重耐药表型;头状葡萄球菌对利奈唑胺耐药由23S rRNA突变及cfr基因导致;长疗程使用利奈唑胺及留置深静脉导管可能是此类耐药菌感染的危险因素。
[Abstract]:Objective to investigate the clinical and pathogenic characteristics of blood flow infection of staphylococcus cephalosporium resistant to linazolamine. Methods the blood isolates of staphylococcus cephalosporium were collected and the drug sensitivity was determined. PCR and sequencing were used to detect the mutation of drug resistance gene cfr and 23s rRNA. The homology of clinical isolates was analyzed by pulsed field gel electrophoresis (PFGE). Results five strains of staphylococcus cephalosporium were isolated from blood samples of 3 patients. These clinical isolates were resistant to oxacillin levofloxacin gentamicin and were only sensitive to glycopeptide rifampicin and trimethoprim sulfamethazole. The 23s rRNA of 5 strains of drug-resistant bacteria were all mutated and 4 strains were carrying cfr gene. PFGE showed that 5 clinical strains belonged to the same spectral type. All the 3 patients had indwelling deep venous catheter and 2 had been treated with linazolamide. Conclusion Linezolium resistant Staphylococcus cephalis showed multiple drug resistance phenotype. The resistance of Staphylococcus cephalis to linazolamide was caused by 23s rRNA mutation and cfr gene. Long-term use of linazolamide and indwelling deep venous catheters may be risk factors for infection of these resistant bacteria.
【作者单位】：复旦大学附属华山医院抗生素研究所卫生部抗生素临床药理重点实验室;
【基金】：国家自然科学基金(81573470) 复旦大学附属华山医院科研启动基金(2014QD18)
【分类号】：R446.5
【正文快照】： 作者单位:复旦大学附属华山医院抗生素研究所,卫生部抗生素临床药理重点实验室,上海200040。杨洋,吴n\,郭燕,叶信予,朱德妹,林东f ,徐晓刚头状葡萄球菌(Staphylococcus capitis)属凝固酶阴性葡萄球菌,既是人类皮肤正常菌群,又是一种条件致病菌,可引起皮肤软组织感染、血流感染

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