耐甲氧西林金黄色葡萄球菌异质性耐药株检测方法探讨  

Investigation of an Appropriate Screening Method for Heterogeneity of Methicillin-Resistant Staphylococcus Aureus

作　　者：于农[1] 张伟[1] 陈建魁[1] 宋世平[1] 金欣[1] 左向华[1] 

机构地区：[1]军事医学科学院附属医院检验科,北京100071

出　　处：《解放军医药杂志》2013年第5期74-76,共3页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

摘　　要：目的探讨耐甲氧西林金黄色葡萄球菌(MRSA)的异质性耐药株的检测方法。方法收集102株金黄色葡萄球菌,采用微量肉汤稀释法分别检测其对头孢西丁、苯唑西林的耐药性,乳胶凝集法检测青霉素结合蛋白2a(PBP2a),同时采用菌群谱分析法对异质性耐药株进行筛选。结果头孢西丁耐药71例(69.6%),其中PBP2a阳性70例(98.6%);苯唑西林耐药80例(78.4%),其中PBP2a阳性70例(87.5%)。头孢西丁耐药菌株PBP2a检出率明显高于苯唑西林(P<0.05)。苯唑西林耐药而头孢西丁敏感的9株菌中筛选出2株(22.2%)异质性耐药株。结论头孢西丁检出MRSA的敏感性优于苯唑西林,但苯唑西林对MRSA异质性耐药菌株检测的敏感性优于头孢西丁。Objective To investigate an appropriate screening method for heterogeneity of methicillin-resistant staphylococcus aureus （H-MRSA）. Methods A total of 102 strains of staphylococcus aureus were isolated and detected drug resistance to Cefoxitin and Oxacillin by broth microdilution method. The positive penicillin-binding protein 2a （PBP2a） was detected by latex agglutination method, and the H-MRSA was isolated with bacteria spectrum analysis at the same time. Results It was found that 71 strains （69.6%） were identified resisted Cefoxitin, and among them PBP2a were found in 70 strains （98.6%） ; 80 strains （78.4%） were found resisting Oxacillin, and among them positive PBP2a were found in 70 strains （87.5%）. Detection rate of drug resistant strain PBP2a in Cefoxitin was significantly higher than that in Oxacillin （P 〈 0.05 ）. Two strains （22.2%） of H-MRSA were isolated from 9 strains, which were re- sistant to Oxacillin and sensitive to Cefoxitin. Conclusion Cefoxitin may be more sensitive than Oxacillin in screening MRSA, whereas Oxacillin may be more sensitive than Cefoxitin in H-MRSA screening.

关 键 词：金黄色葡萄球菌 甲氧西林抗药性 异质性耐药 青霉素结合蛋白2A 头孢西丁 苯唑西林 

分 类 号：R378.11[医药卫生—病原生物学] R446.51[医药卫生—基础医学]