吸毒人员凝固酶阴性葡萄球菌的携带及耐药性  

Carriage and antibiotic resistance of methicillin-resistant coagulase-negative staphylococci among drug users

作　　者：郑浩渠 徐暐杰 王莹莹 郑惠结 叶家萍 周俊立 姚振江 ZHENG Hao-qu;XU Wei-jie;WANG Ying-ying;ZHENG Hui-jie;YE Jia-ping;ZHOU Jun-li;YAO Zhen-jiang(Department of Epidemiology and Health Statistics,Guangdong Pharmaceutical University,Guangzhou 510310,Guangdong,China)

机构地区：[1]广东药科大学公共卫生学院 [2]广州市东仁社区卫生服务中心美沙酮门诊,广东广州510030

出　　处：《广东医学》2018年第23期3525-3528,3533,共5页Guangdong Medical Journal

基　　金：广东省科技厅公益研究与能力建设专项资金(编号:2014A020213013);广东药科大学"创新强校工程"资助项目(2016)

摘　　要：目的掌握广州市美沙酮门诊吸毒人员凝固酶阴性葡萄球菌(CoNS)和耐甲氧西林凝固酶阴性葡萄球菌(MRCoNS)的携带情况,并分析MRCoNS菌株的耐药情况。方法对广州市3个美沙酮门诊353名吸毒人员鼻腔分离出的MRCoNS菌株进行药敏试验和耐药基因检测。结果 353名吸毒人员CoNS携带率为42. 78%,MRCoNS携带率为29. 46%。MRCoNS对青霉素、头孢西丁、红霉素、复方新诺明、克林霉素、莫西沙星、四环素的耐药率较高,主要携带bla Z、msr A、lin A、erm C。MRCoNS菌株的多重耐药率高达65. 18%,而MSCo NS的多重耐药率不仅29. 17%,MRCo NS多重耐药风险是MSCoNS(甲氧西林敏感凝固酶阴性葡萄球菌)的4. 55倍。结论广州市吸毒人群MRCoNS携带率和多药耐药率均偏高,需要加强该人群的卫生防护工作。Objective To investigate the prevalence of coagulase-negative staphylococci( Co NS) and methicillin-resistant coagulase-negative staphylococci( MRCoNS),and their antibiotic resistance among drug users in Guangdong province. Methods All MRCoNS isolated from 353 drug users were tested for antibiotic susceptibility and antibiotic resistance genes. Results Among 353 drug users,the prevalence rates of Co NS and MRCoNS were 42. 78% and29. 46%,respectively. The MRCoNS were mainly resistant to penicillin,cefoxitin,erythromycin,trimethoprim-sulfamethoxazole,clindamycin,moxifloxacin and tetracycline; and mainly carried bla Z,msr A,lin A and erm C genes. The multidrug resistance rate of MRCoNS strain was 65. 18%,while the multidrug resistance rate of MSCoNS was 29. 46%. The risk of multidrug resistance of MRCo NS was 4. 55 times that of MSCo NS. Conclusion Both prevalence and multidrug-resistant rate of MRCoNS are high among drug users in Guangzhou,so strengthening protection in drug users is in need.

关 键 词：凝固酶阴性葡萄球菌 耐甲氧西林凝固酶阴性葡萄球菌 吸毒人员 耐药 耐药基因 

分 类 号：R446.5[医药卫生—诊断学] R749.64[医药卫生—临床医学]