金黄色葡萄球菌临床分离株spa分型和耐药特征研究  

spatyping and resistance profile of Staphylococcus aureus isolated from clinical specimens

作　　者：邹自英[1] 韩黎 熊杰[1] 卢中一[3] 孟祥兆[4] 张雨龙 赵静雅 韩雪琳 田曙光 陈勇 

机构地区：[1]成都军区总医院检验科,成都610083 [2]解放军疾病预防控制所医院感染监控中心 [3]山东农业大学食品科学与工程学院 [4]哈尔滨医科大学附属第二医院

出　　处：《中国感染与化疗杂志》2014年第2期142-145,共4页Chinese Journal of Infection and Chemotherapy

基　　金：国家自然科学基金青年科学基金项目(81102168)

摘　　要：目的研究临床分离金葡菌的耐药性和分子特征。方法对2011年5—11月在成都某医院分离的56株金葡菌进行抗菌药物敏感性检测,检测菌株携带mecA基因和pvl基因情况,并进行spa基因分型分析。结果 56株金葡菌中,共检出耐甲氧西林金葡菌(MRSA)21株(37.5%),其中mecA基因阳性20株(95.2%);甲氧西林敏感金葡菌(MSSA)35株(62.5%)。与MSSA相比,MRSA对利福平、左氧氟沙星、莫西沙星、环丙沙星、庆大霉素和四环素的敏感率显著降低(P<0.05),MRSA对万古霉素、利奈唑胺、替加环素、喹奴普丁-达福普汀和呋喃妥因全部敏感。MRSA分为6个spa型别,以t030(66.7%)为主,MRSA-t030、MRSA-t002具有突出的多药耐药特征。MSSA共分为18个spa型别,以t189、t377和t034列前3位,分别占14.3%、14.3%和11.4%,并在脓液标本检出1株新spa基因型new1。检出5株杀白细胞毒素(PVL)阳性菌株,其中3株为MSSA-t189。结论 t030是医院MRSA临床分离株中的spa优势型别,具有突出的多药耐药特征,在医院内广泛传播。MSSA遗传多样性高,以t189、t377和t034列前3位。Objective To study the resistance and molecular profiles of Staphylococcus aureus strains isolated from the clinical specimens. Methods Antimicrobial susceptibility was tested with 56 strains of Staphylococcus aureus isolated from a hospital from May to November 2011. The mecA and pvl genes were detected. The spa genetic types were analyzed. Results A total of 21 （37.5 ） Sta[JhSococeus aureus strains were resistant to methieillin （MRSA） and 35 （62.5 //00 ） were sensitive to methicillin （MSSA）. Nineteen of the 21 （90.5） MRSA strains carried mecA gene. Compared with MSSA, MRSA were much less sen sitive to rifampin, fluoroqunolones, tetracycline and gentamicin （P%（）. 05）. All the MRSA isolates were susceptible to vanco mycin, linezolid, tigecycline, quinupristin-dalfopristin and nitrofurantoin. Six spa types were identified among the MRSA strains. Type t030 was the most prevalent, accounting for 66.7 （14/21） of all the MRSA strains. MRSA-tII31} and MRSA- t（2 were resistant to multiple antibiotics. Eighteen spa types were identified among the MSSA strains. Type t/89, t377 and t1134 were the top three spa types of MSSA, accounting for 14.3, 14.3 and 11.4, respectively. A new MSSA spa typ- ing strain newl was isolated from pus. There were five Panton-Valentine [eukocidin （PVL）-positive isolates, 3 of which wasMSSA t189 type. Conclusions Type tll30 is the most prevalent ,pa type among clinical MRSA strains, which is resistant to many kinds of antibiotics and widely spreads in the hospital setting. There are many different spa types a- mong the MSSA strains. Type t3b19, t377 and t034 are the top three spa types of MSSA.

关 键 词：金黄色葡萄球菌 spa分型 耐药性 感染控制 

分 类 号：R446.5[医药卫生—诊断学]