50株临床分离金黄色葡萄球菌分子流行病学及药物敏感性分析  

Molecular epidemiology and antimicrobial susceptibility of 50 Staphylococcus aureus strains isolated

作　　者：赵锐[1] 范欣[2] 肖盟[2] 王贺[2] 熊祝嘉[3] 毛镭篥[2] 张力[1] 蔡晶[1] 俞云松[4] 

机构地区：[1]华北电网有限公司北京电力医院检验科,北京100073 [2]中国医学科学院北京协和医院 [3]北京煤炭总医院 [4]浙江大学医学院附属邵逸夫医院

出　　处：《中国感染与化疗杂志》2013年第1期25-30,共6页Chinese Journal of Infection and Chemotherapy

基　　金：卫生部公益性行业科研专项经费(200802107)

摘　　要：目的研究北京电力医院2009年10月至2010年3月连续分离的金葡菌的分子流行病学特征及药物敏感性状况。方法收集在此期间临床连续分离的金葡菌,采用多位点序列分型(MLST)和葡萄球菌蛋白A基因(spa)分型技术进行分子生物学分型,同时进行Panton-Valentine(PVL)毒素基因检测,并对其中的33株甲氧西林耐药金葡菌(MRSA)进行SCCmec分型;采用琼脂稀释法作MRSA对14种抗菌药物的药敏试验。结果 50株金葡菌中,检出MRSA33株,占66.0%,其中1株为社区获得性(CA)-MRSA。MRSA有6种克隆型,其中ST239-t030-Ⅲ型占绝对优势,并且发现了国内罕见的新克隆型(ST239-t2270-Ⅲ)的传播;相比较,MSSA分子分型则呈散在分布。药敏试验结果显示,糖肽类抗生素及替加环素对MRSA的抗菌作用最强。CA-MRSA携带PVL毒素基因,其耐药谱与医院获得性(HA)-MRSA有较大差异。结论相比于MSSA,MRSA的克隆型别相对集中,提示MRSA更容易引起医院内的传播。MRSA以ST239-t030-Ⅲ为最常见型别,与我国总体趋势一致。Objective To investigate the molecular epidemiology and antimicrobial susceptibility of Staphylococcus aureus strains isolated from Beijing Electric Power Hospital during the period from October 2009 to March 2010. Methods A total of 50 S. aureus isolates were collected and analyzed by multiloeus sequence typing （MLST）, Staphylococcus protein A gene （spa） typing and detection of the lukS gene encoding PVL. In addition, SCCmec typing was performed for methicillin-resistant S. aureus （MRSA） isolates. The antimicrobial activities of 14 agents including ceftaroline and tigecycline against MRSA isolates were further determined by agar dilution method. Results Thirty-three strains were identified as MRSA among the 50 S. aureus isolates, including one CA-MRSA. Six clone types were recognized from these MRSA strains. ST239-t030-Ⅲ was the predom- inant type. Prevalence of an unusual molecular type, ST239-t2270-Ⅲ, was observed. In comparison, no significant clonal spread was detected in methicillin-susceptible S. aureus （MSSA）. Glycopeptides and tigecycline showed potent activity againstMRSA. The lukS gene was only identified in the CA-MRSA isolate, which showed the drug resistant pattern different from HA MRSA. Conclusions Unlike MSSA, MRSA showed clustered clonal types, suggesting a nosocomial spread in hospital. The most common molecular clone identi- fied in this hospital was ST239-t030-Ⅲ, which is consistent with the overall situation in China.

关 键 词：金黄色葡萄球菌 分子生物学分型 药物敏感性测定 流行病学分析 

分 类 号：R181.3[医药卫生—流行病学] R446.5[医药卫生—公共卫生与预防医学]