婴幼儿耐甲氧西林金黄色葡萄球菌感染状况和耐药基因的研究  

The suitation of methicillin-resistant Staphylococcus aureus infection in children

作　　者：蔡桂丰[1] 钟莹[1] 汪伟山[1] 周玉球[1] 宋玫[1] 黄辉文[1] 叶兹礼[1] 黄明星[1] 

机构地区：[1]珠海市妇幼保健院生殖中心,广东珠海519000

出　　处：《热带医学杂志》2011年第7期762-764,共3页Journal of Tropical Medicine

基　　金：珠海市科技计划项目(PC20071067)

摘　　要：目的了解感染婴幼儿的耐甲氧西林金黄色葡萄球菌(MRSA)耐药性和耐药基因,明确检测青霉素结合蛋白2a(PBP2a)和甲氧西林耐药基因(mecA)的临床价值。方法用金黄色葡萄球菌乳胶凝集试验和梅里埃鉴定金黄色葡萄球菌,同时用纸片扩散法完成12种常用抗生素的药敏试验。对头孢西丁的结果,按当年CLSI标准执行,用于判断菌株甲氧西林的耐药性。采用PBP2检测试剂盒检测PBP2a蛋白,PCR检测mecA基因。结果 2007-2009年婴幼儿共检出245株金黄色葡萄球菌,其中MRSA检出率为17.6%(43/245)。MRSA对庆大霉素、复方新诺明、克林霉素、红霉素、氯霉素的耐药性均显著高于甲氧西林敏感金黄色葡萄球菌(P<0.05),其余抗生素的差异无统计学意义(P>0.05),43株MRSA的PBP2a蛋白和mecA基因的检测结果全为阳性,阳性率为100%。结论用头孢西丁(30μg)能有效地筛查MRSA,检测PBP2a蛋白和mecA基因均能正确地确认MRSA。且检测PBP2a蛋白方便快捷,特异性好,值得临床推广。Objective To investigate the development of drug-resistance and the clinical values of using the drug resistant genes and PBP2a protein.Methods Staphylococcus aureus were screened by using latex agglutination test and the isolates were identified with GPI card of Biomerieux system.Antimicrobial susceptibility test against 12 antimicrobial agents was performed using the Kurby-Bauer method.CLSI standard was used in the identification of methicillin-resistant Staphylococcus aureus（MRSA）.PBP2a protein was determined using the OXOID＇s reagent（UK）.MecA gene was detected using the polymerase chain reaction（PCR）.Results 245 stains of Staphylococcus aureus were isolated from the outpatients and patients who were hospitalized in Zhuhai Municipal Maternity and Child Healthcare Hospital from January 2007 to December 2009.The MRSA infection rate was 17.6%（43 stains）.The resistance of MRSA to gentamicin,cotrimoxazole,clindamycin,erythromycin and chloramphenicol,was higher than the methicillin sensitive Staphylococcus aureus（P0.05）.The resistance to other antibiotics was similar（P0.05）.All the 43 MRSA isolates were positive in the testing of the PBP2a and the mecA gene.Conclusion MRSA can be screened effectively with cefoxitin（30 μg）.The result can be verified through the identification of PBP2a and mecA.The testing procedure of PBP2a is fast and specific,and the test can be used in the clinic.

关 键 词：耐甲氧西林金黄色葡萄球菌 PBP2a蛋白 血浆凝固酶 耐药性 MECA 

分 类 号：R378.11[医药卫生—病原生物学]