医院感染的金黄色葡萄球菌耐药性与耐药基因检测  

Antibiotics Resistance of Staphylococcus aureus Isolated from Nosocomial Infection Patients and Detection of Resistance Genes

作　　者：茆海丰[1] 刘洪书[1] 赵勇[1] 营丽娟[1] 

机构地区：[1]连云港市第一人民医院,江苏连云港222002

出　　处：《中华医院感染学杂志》2007年第7期790-792,850,共4页Chinese Journal of Nosocomiology

基　　金：CLON-GEN细菌耐药基因专项基金资助(2005016)

摘　　要：目的调查医院感染金黄色葡萄球菌对抗菌药物的耐药性和耐药基因存在状况。方法采用Microscan WalkAway-40检测金黄色葡萄球菌,对19种抗菌药物的耐药性,聚合酶链反应技术(PCR)检测24株甲氧西林敏感金黄色葡萄球菌(MSSA)、16株耐甲氧西林金黄色葡萄球菌(MRSA)的aac(6′)/aph(2″)、aph(3′)-Ⅲ、ant(4′,4″)、TEM、tetM、macA、erm和qacA/B基因。结果医院感染MRSA分离率为59.4%,192株金黄色葡萄球菌β-内酰胺酶阳性率为98.9%,对β-内酰胺类药物耐药率为52.1%～99.0%,对红霉素、克林霉素、克拉霉素、环丙沙星、诺氟沙星、庆大霉素、四环素的耐药率分别为52.1%、78.1%、85.5%、56.3%、61.1%、55.2%、69.8%;对呋喃妥因和复方新诺明耐药率相对较低(1.1%、10.5%),未发现VISA、hVISA和VRSA;MRSA对多种抗菌药物耐药性明显高于MSSA;MRSA与MSSA对8种耐药基因携带率各不相同,MRSA高于MSSA。结论医院感染的金黄色葡萄球菌对抗菌药物有很高的耐药性,MRSA较MSSA的耐药性更高、更复杂,必须加强金黄色葡萄球菌的耐药性监控,以最大限度降低其耐药性的发生。OBJECTIVE To investigate the antibiotics resistance and the presence of resistant gene of Staphylococcus aureus isolated from nosocomial infection patients in our hospital METHODS Antibiotic susceptibility tests were conducted by Microscan WalkAway-40, the antibiotics resistant genes of aac（6＇）/aph（2＂）, aph（3＇）-Ⅲ, ant （4′, 4″）, TEM, tetM, macA, erm and qacA/B of 16 MRSA and 24 MSSA strains were detected by PCR. RESULTS The percentage of MRSA in this investigation was 59. 4%, the positive rate of β-lactamases of 192 S. aureus strains was 98. 9%, resistant rate of S. aureus to β-lactam antibiotics was 52. 1-99. 0%, and to erythromycin, clindamycin, clarithromycin, ciprofloxacin, norfloxacin, gentamicin and tetracycline was 52.1%, 78. 1%, 85. 5%, 56. 3%, 61. 1%, 55. 2%, and 69. 8%, respectively, but to nitrofurantoin and sulfamethoxazole/trimethoprim were relatively lower （1. 1 % and 10. 5%） than the others. VISA, h-VISA and VRSA were not measured. To the most of antibiotics, the resistant rate of MRSA was higher than MSSA. The presence of resistant gene of MRSA and MSSA was different. There was more positive percentage of gene in MRSA than in MSSA. CONCLUSIONS Antibiotics resistance of S. aureus isolated from nosocomial infection patients in our hospital is severe. Compared to MSSA, MRSA has higher antibiotic resistant rate and more complicated drug-resistant mechanism. Some measures should be done to reduce the antibiotic resistance of S. aureus.

关 键 词：金黄色葡萄球菌 医院感染 耐药性 

分 类 号：R378.11[医药卫生—病原生物学]