耐甲氧西林溶血葡萄球菌耐药性及耐药基因研究  

Drug-resistance and drug-resistant genes of methicillin-resistant Staphylococcus haemolyticus

作　　者：黄峰[1] 秦淑国[1] 边其侠 许元元[1] 

机构地区：[1]宿州市皖北煤电集团总医院,安徽宿州234000

出　　处：《中国感染控制杂志》2012年第2期91-96,共6页Chinese Journal of Infection Control

摘　　要：目的了解安徽省宿州地区临床分离的耐甲氧西林溶血葡萄球菌(MRSH)耐药性、耐药基因携带状况及诱导型克林霉素耐药的发生率。方法采用ATB STAPH5药敏试验板微量肉汤法对42株MRSH进行16种抗菌药物敏感性测定;聚合酶链反应(PCR)法检测MRSH中mecA、qacA/B/C、qacA、ermA/B/C、ermB、TetM耐药基因;D-试验检测诱导型克林霉素耐药表型。结果 42株MRSH对万古霉素、呋喃妥因100%敏感,对利福平、米诺环素、奎奴普丁/达福普汀、替考拉宁的敏感率>90%;而对庆大霉素、诺氟沙星、左氧氟沙星的耐药率>70%,对青霉素、苯唑西林、红霉素耐药率为100.00%。mecA、qacA/B/C、qacA、ermA/B/C、ermB、TetM基因阳性率分别为100.00%(42株)、64.29%(27株)、59.52%(25株)、40.48%(17株)、28.57%(12株)、9.52%(4株)。D-试验阳性13株,诱导性耐药占30.95%。结论安徽宿州地区分离的MRSH呈多重耐药性,临床治疗应根据药敏试验结果合理选用抗菌药物。Objective To investigate the drug-resistance,drug-resistant genes and prevalence of reducible clindamycin resistance of methicillin-resistant Staphylococcus haemolyticus（MRSH） in Suzhou district of Anhui province.Methods Susceptibility of 42 MRSH isolates to 16 kinds of antimicrobial agents were performed with ATB STAPH5 strip microdilute testing;drug-resistant genes mecA,qacA/B/C,qacA,ermA/B/C,ermB and TetM in MRSH were detected with polymerase chain reaction;inducible clindamycin resistance was detected with D-test.Results Sensitive rates of 42 MRSH isolates to vancomycin and nitrofurantoin were both 100.00%,sensitive rates to rifampicin,minocycline,quinupristin/dalfopristin and teicoplanin were all 90%;resistant rates to gentamicin,norfloxacin and levofloxacin were all 70%,resistant rates to penicillin,oxacillin and erythromycin were all 100.00%.The positive rate of mecA,qacA/B/C,qacA,ermA/B/C,ermB and TetM gene was 100.00%（42 isolates）,64.29%（27）,59.52%（25）,40.48%（17）,28.57%（12） and 9.52%（4） respectively.13 MRSH isolates were D-test positive,30.95% of which was inducible drug-resistance.Conclusion MRSH isolated from Suzhou district of Anhui province showed multi-drug resistance,antimicrobial agents should be chosen rationally according to antimicrobial susceptibility testing results.

关 键 词：耐甲氧西林溶血葡萄球菌 抗菌药物 耐药基因 微生物敏感性试验 抗药性 微生物 合理用药 

分 类 号：R378.11[医药卫生—病原生物学]