49株耐甲氧西林金黄色葡萄球菌的耐药性分析及pvl基因检测  

The drug resistance analysis of 49 strains HA-MRSA and pvl genetic testing

作　　者：冯秀丽 杨璐嘉 张楚楚[2] 

机构地区：[1]新疆兵团第七师医院,新疆奎屯833200 [2]大连医科大学检验医学院,辽宁大连116044

出　　处：《中国卫生检验杂志》2015年第11期1807-1810,共4页Chinese Journal of Health Laboratory Technology

基　　金：新疆兵团医药卫生科技攻关计划课题(2013BA023)

摘　　要：目的通过分析济宁医附院院内分离的49株耐甲氧西林金黄色葡萄球菌(MRSA),对16种抗生素的耐药性及菌株对杀白细胞素(PVL)的携带情况,了解MRSA的院内流行状况,为临床用药提供参考依据。方法 K-B法检测临床分离出的49株MRSA对16种抗生素的耐药情况,聚合酶链反应(PCR)检测MRSA对pvl基因的携带情况。结果药敏结果显示,49株MRSA除对β-内酰胺类抗生素100%耐药外,对万古霉素、替加环素、利奈唑胺均不耐药,对大环内酯类抗生素红霉素、克林霉素呈较高的耐药性。是否携带pvl基因对菌株耐药性也有影响。49株院内MRSA中检出12株菌株携带pvl基因,占24.5%,另外37株MRSA为pvl基因阴性,占75.5%。结论该院临床分离出的MRSA耐药性较高,治疗应以糖肽类抗生素为主,合理规范用药,加强对pvl基因的监测,防止此类菌株的播散。Objective By analyzing 49 strains of hospital - acquired Methicillin - resistant Staphylococcus aurens （ HA - MARA） from Jining hospital on 16 kinds of antibiotics resistance and strain Panton -Valentine Leukocidin（pvl） carrying case, so as to the epidemic of MRSA in hospital and provide reference for the clinical drug application. Methods Kirby - Bauer method was used to detect the resistance of 16 kinds of antibiotic to 49 strains HA - MRSA, and pvl was detected by PCR. Re- suits The susceptibility results showed that the resistant rate of 49 MRSA for β - lactam antibiotic was the highest with the rate of 100%, and they were not resistant to vancomycin, tigecycline, linezolid, and also showed higher resistant rates to Erythromycin and Clindamycin of macrolides ntibiotics. Whether carrying the pvl gene had an impact on strains resistance. 12 strains car- rying the pvl gene was detected from 49 HA - MRSA, accounting for 24.5% , and the other 37 strains for the pvl - negative MR- SA accounted for 75.5%. Conclusion This hospital clinical isolated MRSA has high resistant rate. Treatment should be based on glycopeptide antibiotics. It should be strengthened for the reasonable medication and the monitoring of the pvl gene to prevent the spread of such strains.

关 键 词：耐甲氧西林金黄色葡萄球菌 耐药性 杀白细胞素 

分 类 号：R446.5[医药卫生—诊断学]