糖尿病足感染中耐甲氧西林表皮葡萄球菌SCCmec分型临床研究  

SCCmec genotypes of methicillin-resistant Staphylococcus epidermidis in diabetic foot infections

作　　者：丁群[1] 王鹏华[1] 褚月颉[1] 冯书红[1] 孟树优[1] 孙茜[1] 李代清[1] 

机构地区：[1]天津医科大学代谢病医院,卫生部及天津市激素与发育重点实验室,300070

出　　处：《中华微生物学和免疫学杂志》2011年第1期51-54,共4页Chinese Journal of Microbiology and Immunology

摘　　要：目的 研究分离于糖尿病足感染（DFI）溃疡创面的耐甲氧西林表皮葡萄球菌（MRSE）的SCCmec分型特点及不同型别的耐药特征.方法 2008年1月-2010年6月从天津某医院390例DFI溃疡中分离出70株表皮葡萄球菌,提取细菌的DNA,用聚合酶链反应（PCR）方法检测mecA基因,并对MRSE进行SCCmec分型;采用K-B纸片法进行药敏试验,分析不同SCCnec型别的耐药特点.结果 20株（28.6%,20/70）mecA均为阳性,SCCmec分型：Ⅱ型2例（10.0%）、Ⅲ型9例（45.0%）、Ⅳ型9例（45.0%）,未发现Ⅰ型和Ⅴ型菌株.20株SCCmecⅡ、Ⅲ型或Ⅳ型菌株,均为多重耐药菌,除了对β-内酰胺类（包括青霉素类、头孢西丁、头孢类）耐药外,对大环内酯类、磺胺类、喹诺酮类等非β-内酰胺类抗菌药物耐药率也较高.所有菌株都对万古霉素和利福平敏感.结论 DFI溃疡中分离的MRSE以SCCmecⅢ型和Ⅳ型菌株为主,SCCmecⅣ型菌株已在DFI溃疡中传播并且对多种药物耐药.Objective To investigate SCCmec genotypes and drug-resistance profiles of the methieillin-resistant Staphylococcus epidermidis （MRSE） strains isolated from the patients suffered from diabetic foot infections （DFI） in the Tianjin Metabohc Diseases Hospital. Methods After dabridement, specimens of 390 infectious diabetic foot ulcers in the hospital from Jan 2008 to Jun 2010 were collected from the wound basal parts by cotton swab for culture. The disk-diffusion method was performed to examine antimicrobial susceptibility. DNAs of the MRSE strains were extracted, and their SCCmec genotypes were identified by PCR. Results Twenty of the seventy（28.6% ,20/70）Staphylococcus epidermidis strains were mecA posifive. Among the MRSE isolates, 2 （ 10.0% ）were SCCmec Ⅱ ,9 （45.0%）were SCCmecⅢ and 9 （45.0%）were SCCmec Ⅳ. None of the isolates were genotyped as SCCmec Ⅰ or Ⅴ. No mater which genotypes they were, all the MRSE isolates were multi-drug resistant. They were resistant not only to β-lactams （including penicillins, cefoxitin and cephems）, but also to non-β-lactams （including macrolides, fiuoroquinolones and sulfonamides ） . Resistance to voncomycin and rifampicin were not found in these strains . Conclusion SCCmec Ⅲ and SCCmecⅣ are major genotypes of the MRSE isolates from the infectious diabetic foot ulcers.The SCCmec Ⅳ genotype strains with multi-drug resistant profiles are prevalent in the diabetic foot infections.

关 键 词：糖尿病足感染 耐甲氧西林表皮葡萄球菌 SCCmec分型 

分 类 号：R587.2[医药卫生—内分泌]