婴幼儿感染金黄色葡萄球菌耐药性与耐药基因研究  

Drug resistance of Staphylococcus aureus causing infection in infants and drug resistance genes

作　　者：谈华[1] 徐嘉昌[1] 刘雪梅[1] 迟富丽[1] 徐飞[1] 曹波[1] 赵呈元[1] 常勇[1] 虞伟[2] 

机构地区：[1]南京医科大学附属南京儿童医院检验科,江苏南京210008 [2]南京军区南京总医院解放军临床检验医学研究所,江苏南京210002

出　　处：《中华医院感染学杂志》2014年第24期5981-5983,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81071419);江苏省科技支撑计划基金资助项目(BE2011786)

摘　　要：目的调查婴幼儿感染标本分离的金黄色葡萄球菌耐药性与耐药基因携带状况。方法收集南京市儿童医院2013年10-12月婴幼儿感染标本分离出的金黄色葡萄球菌20株,首先采用K-B法和E-test法做抗菌药物敏感性试验,再用聚合酶链反应(PCR)的方法分析β-内酰胺类药物耐药基因(blaZ、mecA)及大环内酯类药物耐药基因(ermA、ermB、ermC、mphC、msrA)。结果 20株金黄色葡萄球菌对头孢西丁、青霉素、红霉素、克林霉素的耐药率,分别为50.0%、100.0%、40.0%、40.0%;耐药基因共检出mecA基因11株占55.0%、ermB基因1株占5.0%、ermC基因7株占35.0%;该组菌中17号株对头孢西丁敏感,检出mecA基因,其他菌株头孢西丁药敏结果耐药株均能检出mecA基因,头孢西丁敏感株均未检出mecA基因。结论 mecA、ermB、ermC基因是该组菌对β-内酰胺类和大环内酯类药物耐药的重要原因,对婴幼儿感染标本分离的金黄色葡萄球菌进行β-内酰胺类药物耐药基因(blaZ、mecA)及大环内酯类药物耐药基因(ermA、ermB、ermC、mphC、msrA)检测研究尚为国内首次。OBJECTIVE To investigate the drug resistance of the Staphylococcus aureus isolates from specimens of the infants with infections and analyze the drug resistance genes in the strains .METHODS A total of 20 strains of S .aureus were isolated from the specimens of the infants with infections who were treated in Nanjing Children′s Hospital Affiliated to Nanjing Medical University from Oct 2013 to Dec 2013 ,then the drug susceptibility testing was performed by using K‐B method and E‐test ,theβ‐lactams resistance genes （blaZ、mecA ） and the macrolides resistance genes （ermA , ermB , ermC , mphC , msrA ） were analyzed by means of polymerase‐chain‐reaction （PCR） .RESULTS The drug resistance rates of the 20 strains of S .aureus to cefoxitin ,penicillin ,erythromycin , and clindamycin were 50 .0% ,100 .0% ,40 .0% ,and 40 .0% ,respectively .Th emecA gene was detected in 11 （55 .0% ） strains ,the ermB gene in 1 （5 .0% ） strain ,the ermC gene in 7 （35 .0% ） strains .In this group of strains ,the strain NO .17 was susceptible to cefoxitin ,with the mecA gene tested positive ;the results of the drug susceptibility testing for other strains showed that all the drug resistant strains were tested positive for the mecA gene ,while the mecA gene was not detected in the cefoxitin‐sensitive strains .CONCLUSION The mecA ,ermB , and ermC are the leading causes of drug resistance of this group of strains to β‐lactams and macrolides .It is for the first time in China to detect theβ‐lactams resistance genes （blaZ ,mecA ） and macrolides resistance genes （ermA , ermB ,ermC ,mphC ,msrA） in the S .aureus strains isolated from the infants with infections .

关 键 词：金黄色葡萄球菌 耐药性 耐药基因 Β-内酰胺类 大环内酯类 

分 类 号：R378.11[医药卫生—病原生物学]