耐甲氧西林金黄色葡萄球菌耐药性分析及mecA和PVL基因检测

发布时间：2018-03-29 11:42

本文选题：耐甲氧西林金黄色葡萄球菌　切入点：耐药性　出处：《临床和实验医学杂志》2017年01期

【摘要】：目的检测临床分离耐甲氧西林金黄色葡萄球菌(MRSA)mec A基因和杀白细胞素(PVL)基因携带情况,并分析其对常用抗菌药物的耐药性,指导临床上合理规范用药。方法应用96孔肉汤微量稀释法对菌株进行10种常用抗菌药物敏感性试验,全部药物敏感试验采用MIC法鉴定,采用聚合酶链反应(PCR)法检测mec A基因和PVL基因携带情况,并对PVL基因阳性菌株感染患者的临床资料进行分析。结果 60株MRSA对克林霉素、庆大霉素、利福平耐药率均80%,环丙沙星、莫西沙星、左氧氟沙星耐药率均90%,对呋喃妥因,复方新诺明较敏感,耐药率10%,60株MRSA对万古霉素,利奈唑胺均敏感。60株MRSA的mec A基因均为阳性,其中检出3株菌株携带PVL基因,占5.0%,另外57株MRSA为PVL基因阴性,占95.0%。结论本地区临床分离出的MRSA耐药性较高,以携带mec A耐药基因为主,因此治疗应以糖肽类抗生素为主,合理规范用药。MRSA-PVL基因阳性率相对较低,但其与一些严重的金黄色葡萄球菌感染有关,临床应予以关注并加强对PVL基因的监测,有效控制及防止此类菌株播散流行。
[Abstract]:Objective to detect the prevalence of MRSA-mec A gene and PVL gene in clinical isolates of methicillin-resistant Staphylococcus aureus, and to analyze their resistance to common antimicrobial agents. Methods 10 common antimicrobial susceptibility tests were carried out with 96 well broth microdilution method, and all drug sensitivity tests were identified by MIC method. Mec A gene and PVL gene were detected by polymerase chain reaction (PCR), and the clinical data of patients infected with PVL gene positive strains were analyzed. Results 60 strains of MRSA were treated with clindamycin and gentamicin. The resistant rates of rifampicin, ciprofloxacin, moxifloxacin and levofloxacin were 90 and 90 respectively. The drug resistance rates of 100.60 strains of MRSA were positive for vancomycin, and 60 strains of MRSA were positive for MRSA. Among them, 3 strains were found to carry PVL gene, accounting for 5.0%, and 57 strains of MRSA were negative for PVL gene, accounting for 95.0.Conclusion the drug resistance of MRSA isolated from our region is higher, and the drug resistance gene of mec A is the main one. Therefore, glycopeptide antibiotics should be used as the main therapy. The positive rate of MRSA-PVL gene is relatively low, but it is related to some serious Staphylococcus aureus infection. We should pay close attention to it in clinic and strengthen the monitoring of PVL gene to effectively control and prevent the spread of these strains.
【作者单位】：首都医科大学附属北京友谊医院检验科;
【分类号】：R446.5

【相似文献】