金黄色葡萄球菌对万古霉素耐药情况调查  

A survey on resistance of Staphylococcus aureus to vancomycin

作　　者：代洪[1] 范学工[1] 

机构地区：[1]中南大学湘雅医院传染科,长沙410008

出　　处：《临床检验杂志》2005年第4期259-262,共4页Chinese Journal of Clinical Laboratory Science

摘　　要：目的调查金黄色葡萄球菌(Staphylococcusaureus)对万古霉素的耐药情况,并对敏感性降低菌株进行基因分型。方法对132株临床分离的金黄色葡萄球菌分别进行2μg/ml、4μg/ml万古霉素脑心浸液琼脂生长试验,4μg/ml生长试验阳性菌株用随机引物聚合酶链反应进行基因分型。并用菌群分析法筛查对万古霉素异质性耐药金黄色葡萄球菌。结果62株(47.0%)金黄色葡萄球菌能在含2μg/ml万古霉素的脑心浸液琼脂上生长,9株(6.8%)金黄色葡萄球菌能在含4μg/ml万古霉素的脑心浸液琼脂上生长,但其MIC皆≤2μg/ml。9株菌株都能产生独特稳定的AP-PCR谱型。有1株金黄色葡萄球菌对万古霉素异质性耐药。结论未发现对万古霉素完全耐药或中介耐药的金黄色葡萄球菌,异质性耐药金黄色葡萄球菌分离率为0.75%;在本地区尚无对万古霉素敏感性降低的同源株的流行趋势。Objective To Survey the resistance of Staphylococcus aureus to vancomycin and genotype Staphylococcus aureu with decreased vancomycin-susceptibility.Methods One hundred and thirty-two strains of Staphylococcus aureu were investigated by growing test on brain-heart infusion (BHI) medium containing 2 microgram/mL and 4 microgram/mL of vancomycin respectively.The stains which grew on BHI medium containing 4 microgramme/mL of vancomycin were genotyped by arbitrarily primed polymerase chain reaction (AP-PCR).Heterogeneous vancomycin-resistant Staphylococcus aureus (hetero-VRSA) isolate was screened and identified by bacterial population analysis method.Results Among the 132 clinical isolates,62(47.0%)stains grew on BHI medium containing 2 microgram/mL of vancomycin.Nine (6.8%) stains grew on BHI medium containing 4 microgram/mL of vancomycin and showed stable and distinct AP-PCR pattern,but the MIC of vancomycin for all the 9 strains were less than 2 microgram/ml.One strain with hetero-VRSA was isolated and identified.Conclusion None of Staphylococcus aureus isolates was confirmed as vancomycin-complete resistance or vancomycin-intermediate resistance.The percentage of hetero-VRSA was 0.75%.There was no prevalent tendency of decreased susceptibility of Staphylococcus aureu to vancomycin.

关 键 词：万古霉素 耐药情况 耐药金黄色葡萄球菌 随机引物聚合酶链反应 敏感性降低 基因分型 生长试验 异质性耐药 临床分离 中介耐药 流行趋势 ml 菌株 琼脂 浸液 脑心 分析法 MIC PCR 全耐药 未发现 分离率 

分 类 号：R978.1[医药卫生—药品] R563[医药卫生—药学]