130例表皮葡萄球菌临床分离株的耐药性分析和mecA/icaA/icaD基因研究  

Study of antibiotics resistance and mec A/ica A/ica D genes of 130 cases of Staphylococcus epidermidis

作　　者：曹蕴[1] 李家斌[1] 

机构地区：[1]安徽医科大学第一附属医院,合肥230022

出　　处：《中国抗生素杂志》2014年第9期683-687,共5页Chinese Journal of Antibiotics

基　　金：国家自然科学基金(No.81172737)

摘　　要：目的了解蚌埠医学院第一附属医院2013年检出130株表皮葡萄球菌的临床分布特征,研究其耐药性和mec A/ica A/ica D基因的携带等情况,为临床合理使用抗生素提供实验依据。方法 130株表皮葡萄球菌采用法国梅里埃VITEK2-compact全自动细菌鉴定药敏分析仪和配套的药物敏感复合板,血培养系统采用美国BD公司的全自动血培养仪进行菌种鉴定和药物敏感试验。研究数据采用SPSS 18.0软件进行统计分析;用PCR方法检测mec A/ica A/ica D基因。结果本年度,共检出130株表皮葡萄球菌,主要来自于外科32株(24.61%),ICU科23株(17.69%),儿科18株(13.85%)和感染科16株(12.31%);以血液,脑脊液,骨髓来源为主(113株,86.92%)。检出耐甲氧西林的表皮葡萄球菌(MRSE 110株,84.62%),明显高于甲氧西林敏感的表皮葡萄球菌(MSSE),其差异有统计学显著性(P<0.05)。对MRSE敏感率较高的抗生素主要为:利奈唑胺(100%),万古霉素(100%),呋喃妥因(98.18%),利福平(77.27%),莫西沙星(72.73%)和庆大霉素(70.00%)等。mec A/ica A/ica D基因在血培养来源(20株),分别与非血培养来源(10株)和环境皮肤来源(9株)表皮葡萄球菌的检出率,结果比较无显著性差异。结论我院分离的表皮葡萄球菌,以MRSE为主,未发现耐万古霉素表皮葡萄球菌,表皮葡萄球菌mec A阳性率极高,ica A和ica D基因阳性率较低。Objective To investigate the antibiotic sensitivity and mecA/icaA/icaD status of 130 cases of Staphylococcus epidermidis （SE） in the first affiliated hospital of Bengbu medical college in 2013. Methods French Merieux VITEK2-compact microbiology analyzer was used for identifying organisms and detecting antibiotic sensitivity, mecA, icaA and icaD were detected by PCRs. SPSS 18.0 softwares were employed for statistical analysis. Results The 130 SE strains were mainly isolated from Surgery （24.61%）, ICU Branch （17.69%）, Pediatrics（13.85%）, Infectious Diseases （12.31%）, while the 130 strains were mainly isolated from blood, marrow and CSF （113, 86.92%）. Among these strains, methicillin-resistant Staphylococcus epidermidis （MRSE） accounted for 84.62%. The resistance rates of MRSE were significantly higher than those of methicillin-susceptible Staphylococcus epidermidis （MSSE） to the above antibiotics （P〈0.05）. The antibiotics with high sensitive rates for MRSE were vancomycin （100%）, linezolid （100%）, rifampin （98.18%）, nitrofurantoin （77.27%）, moxifloxacin （72.73%） and gentamincin （70.00%）. There were no statistically significant differences between SE isolated blood and non-blood in the rates of mecA, icaA or icaD genes. Conclusion Most of SE are MRSE, β-1actamase positive and multi-drug-resistant. SE show high incidence of mecA gene and low incidence of icaA/icaD genes in this study.

关 键 词：表皮葡萄球菌 耐药性 MECA基因 icaA和icaD基因 

分 类 号：R378.1[医药卫生—病原生物学]