济南地区异质性万古霉素中介金葡菌的分离率及方法研究  

Prevalence and screening methods of hetero-resistant vancomycin-intermediate staphylococcus aureus in the Jinan region

作　　者：毕少杰[1] 于晶 刘婷[3] 刘明涛[4] 盛美艳[4] 李玉[4] 

机构地区：[1]山东大学第二医院心内科,济南250033 [2]山东医学高等专科学校,济南250002 [3]山东大学第二医院检验科,济南250033 [4]山东大学齐鲁医院呼吸科,济南250012

出　　处：《山东大学学报（医学版）》2010年第6期41-44,48,共5页Journal of Shandong University:Health Sciences

基　　金：山东省科技攻关项目(2006GG2202013)

摘　　要：目的了解济南地区临床MRSA标本中异质性万古霉素中介金葡菌(hVISA)的分离率,并对三种筛选方法进行探讨。方法对216株临床分离的耐甲氧西林金葡菌(MRSA)分别进行2μg/mL万古霉素(BHIV2)、4μg/mL万古霉素(BHIV4)及5μg/mL替考拉宁(BHIT5)脑心浸液琼脂筛选法初筛,对阳性菌株进行macroEtest(MET)法及改良菌群分析策略-曲线下面积法(PAP-AUC)确认。结果 BHIV2、BHIV4、BHIT5筛选法初筛的菌株数分别为143、19和110株,初筛菌株最终确认29株,确认率分别为16.1%、73.7%和19.1%,则济南地区hVISA的分离率至少为13.4%(29/216)。结论在济南地区临床分离的MRSA菌中hVISA占有一定比例;在三种筛选方法中,BHIV2和BHIT5筛选法的敏感性高于BHIV4筛选法,特异性低于BHIV4筛选法,而BHIV2和BHIT5筛选法之间无差异。Objective To investigate the prevalence of hetero-resistant vancomycin-intermediate staphylococcus aureus and compare three screening methods. Methods 216 strains of methicillin-resistant staphylococcus aureus（MRSA） were preliminarily screened by brain heart infusion agar with 2mg/liter vancomycin （BHIV2）,4mg/liter vancomycin （BHIV4） or 5mg/liter teicoplanin （BHIT5）. Positive strains were confirmed by macroEtest（MET） and population analysis profile-area under the curve（PAP-AUC）. Results In 216 strains of clinical MRSA,the isolating rate of hVISA was at least 13.4%. In BHIV2,BHIV4 and BHIT5 screening methods,the preliminarily screened positive strains were 143,19 and 110,respectively,with finally confirmed rates of 16.1%,73.7% and 19.1%,respectively. Conclusion Some strains of hVISA exist in MRSA isolated from clinics of the Jinan region. Among the three methods,sensitivities in BHIV2 and BHIT5 methods are higher than that in the BHIV4 method. However,specificities in the BHIV2 and BHIT5 methods are lower than that in the BHIV4 method. There are no significant differences in sensitivity and specificity between the BHIV2 and BHIT5 methods.

关 键 词：金黄色葡萄球菌 万古霉素 异质性耐药 

分 类 号：R446.5[医药卫生—诊断学]