老年病房耐甲氧西林金黄色葡萄球菌葡萄球菌染色体mec基因盒基因型和杀白细胞素基因的检测及特点  

Leukocidin prevalence and molecular epidemiology of methicillin-resistant Staphylococcus aureus in geriatric wards

作　　者：朱砚萍[1] 瞿介明[1] 朱惠莉[1] 陆运涛[1] 徐轶[1] 庞立峰[2] 方毅[2] 

机构地区：[1]复旦大学附属华东医院呼吸科,上海200040 [2]复旦大学附属华东医院检验科,上海200040

出　　处：《上海医学》2013年第1期10-14,共5页Shanghai Medical Journal

基　　金：上海市医学会临床医学科研专项资金资助项目(SMJ2010008)

摘　　要：目的了解复旦大学附属华东医院老年科临床分离的耐甲氧西林金黄色葡萄球菌(MRSA)葡萄染色体mec基因盒(SCCmec)的分布和杀白细胞毒素(PVL)基因的携带状况。方法收集复旦大学附属华东医院老年科病房2011年2—7月从临床标本中分离的不重复MRSA共57株。运用多重聚合酶链反应检测金黄色葡萄球菌16SrRNA基因、PVL基因和mecA基因,并同时检测SCCmec的基因型及亚型。采用琼脂稀释法进行13种药物的药物敏感试验。结果 57株MRSA中,SCCmecⅠ型1株(1.8%),SCCmecⅠA型5株(8.7%),SCCmecⅡ型30株(52.6%),SCCmecⅢ型15株(26.3%),SCCmecⅢA型2株(3.5%),4株(7.0%)未能分型。57株MRSA中,PVL基因均为阴性。MRSA菌株最敏感的药物为万古霉素和利奈唑胺(敏感率均为100.0%),其次为呋喃妥因和甲氧苄啶-磺胺甲口恶唑(98.2%、96.5%)。结论复旦大学附属华东医院老年科临床分离的MRSA呈多重耐药,其SCCmec型别主要以SCCmecⅡ型和SCCmecⅢ型为主,未发现PVL基因阳性菌株。Objective To investigate the prevalence of staphylococcal cassette chromosome mec （SCOmec） and panton-valentine leukocidin （PVL） in methicillin-resistant Staphylococcus aureus （MRSA） isolated from geriatric wards in our hospital. Methods A total of 57 strains of MRSA were isolated from various specimens between February and July 2011. The 16S rRNA gene, PVL gene and mecA gene of MRSA were examined by multiplex polymerase chain reaction（PCR）. The SCCmec genotype and subtype of MRSA was examined by PCR. Antibiotic susceptibility test was performed for 13 medicines by broth microdilution. Results There were one strain of SCOmec type Ⅰ （1.8%）, 5 strains of SCCmec type Ⅰ A （8.7%）, 30 strains of SCCmec type Ⅱ （52.6 % ）, 15 strains of SCOmec type Ⅲ（26.3 % ）, and 2 strains of SOCmec type Ⅲ A （3.5 % ）. Another 4 strains of MRSA could not be classified. PVL gene was negative in all the strains. Vancomycin and linezolid were the most potent drugs against MRSA （sensitivity 100.0% ）, followed by nitrofurantoin （98.2%） and trimethoprim- sulfamethoxazole （96.5%）. Conclusion The strains of MRSA from the geriatric wards in our hospital are multiresistant to antibiotics. SCOmec type Ⅱ and Ⅲ are the major genotypes of MRSA. No PVL gene-positive MRSA is found.

关 键 词：耐甲氧西林金黄色葡萄球菌 杀白细胞毒素基因 葡萄球菌染色体mec基因盒分型 多重聚合酶链反应 老年病房 

分 类 号：R446.5[医药卫生—诊断学]