耐甲氧西林金黄色葡萄球菌SCCmec基因分型及耐药谱分析  

Staphylococcal cassette chromosome mecgenotypes and antimicrobial resistance spectrum of meticillin-resistant Staphylococcus aureus

作　　者：陈洁[1] 李岩[1] 王晶[1] 韩丽霞[1] 肖晓光[1] 林琳[1] 

机构地区：[1]大连医科大学附属第一医院检验科,辽宁大连116011

出　　处：《中华医院感染学杂志》2012年第5期894-897,共4页Chinese Journal of Nosocomiology

摘　　要：目的研究耐甲氧西林金黄色葡萄球菌(MRSA)SCCmec基因分型情况,并对其耐药谱进行分析。方法收集从临床标本分离出的MRSA 91株,应用多重PCR法对MRSA进行SCCmec基因分型,采用MicroScanWalk-Away-40全自动微生物鉴定药敏分析仪进行细菌的鉴定及药敏试验,部分药敏试验采用K-B法。结果 91株MRSA中SCCmecⅡ型72株,占79.1%,SCCmecⅢ型16株,占17.6%,未分型3株,占3.3%,未见SCCmecⅠ型及SCCmecⅣ型;ICU中MRSA所占比例最多,为SCCmecⅡ型51.4%、SCCmecⅢ型37.5%,2种SCCmec基因型的MRSA对万古霉素、磺胺甲噁唑/甲氧苄啶、利奈唑胺、喹奴普汀/达福普汀的耐药率为0,对氯霉素的耐药率分别为11.1%和12.5%,对利福平的耐药率分别为8.3%和37.5%,其余均呈高水平耐药,2种SCCmec基因型的MRSA均表现为多药耐药。结论临床分离的MRSA以SCCmecⅡ型为主,且对抗菌药物呈多药耐药。OBJECTIVE To study the genotyping of staphylococcal cassette chromosome mec（SCCmec） and analyze the antimicrobial resistance spectrum of meticillin-resistant Staphylococcus aureus（MRSA）.METHODS A total of 91 strains of MRSA were collected from clinical samples and the genotypes of SCCmec were determined by multiplex PCR.Bacterial identification and antimicrobial susceptibility testing were performed by MicroScanWalkAway-40 full automatic microorganism identification and antimicrobial susceptibility testing system.Part of drug susceptibility tests were performed by the Kirby-Bauer method.RESULTS Among 91 strains of MRSA,72（79.1%）strains belonged to SCCmecⅡ,16（17.6%）strains belonged to Sccmec Ⅲ,3 strains were without genotyping,SCCmecⅠand SCCmec Ⅳ were not found.MRSA was predominant in ICU,SCCmec Ⅱ accounted for 51.4%,and SCCmecⅢ accounted for 37.5%.The resistance rates of the two SCCmec genotypes of MRSA to vancomycin,sulfamethoxazole/trimethoprim,linezolid and quinupristin/dalfopristin were 0,to chloromycetin were 11.1% and 12.5% respectively,to rifampin were 8.3% and 37.5% respectively.Both of them had high-level resistance to other antibiotics,both presented multidrug-resistance.CONCLUSION SCCmec Ⅱ is the major genotype of MRSA which presents multidrug-resistance to antibiotics.

关 键 词：耐甲氧西林金黄色葡萄球菌 葡萄球菌染色体基因盒 多重聚合酶链反应 

分 类 号：R378.11[医药卫生—病原生物学]