青岛部分地区MRSA和MRCNS的SCCmec分型及耐药性  

GENOTYPING OF SCCMEC GENE AND DRUG RESISTANCE OF METICILIN-RESISTANT STAPHYLOCOCCUS IN PARTS OF QINGDAO AREA

作　　者：于淼[1,2] 赵自云[2] 牟晓峰[2] 刘成玉[1] 

机构地区：[1]青岛大学医学院诊断学教研室,山东青岛266021 [2]青岛大学医学院第二附属医院检验科,山东青岛266021

出　　处：《青岛大学医学院学报》2015年第3期293-295,299,共4页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的了解青岛部分地区耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)SCCmec分型及其对临床常用抗生素的耐药情况,为指导临床合理使用抗生素及明确本地区MRSA流行趋势提供依据。方法收集从各种临床标本中分离的75株MRSA和18株MRCNS。采用MicroScanWalkAway-96全自动微生物鉴定仪和药敏分析系统,对菌株进行细菌鉴定和药物敏感试验。采用多重PCR法分别对MRSA和MRCNS菌株进行SCCmec分型。结果 MRSA对利福平、克林霉素的耐药率分别为76.0%、81.3%,均高于MRCNS的50.0%、50.0%,差异有显著性(χ2=30.690、7.656,P<0.05)。MRSA对庆大霉素、左旋氧氟沙星的耐药率均为82.7%,均高于MRCNS的5.6%、44.4%,差异有显著统计学意义(χ2=6.864、9.432,P<0.05)。75株MRSA中SCCmecⅢ型64株(85.3%),SCCmecⅡ型5株(6.7%),未分型6株(8.0%);18株MRCNS中SCCmecⅢ型5株(27.8%),SCCmecⅡ型2株(11.1%),SCCmecⅤ型5株(27.8%),SCCmecⅢ型、Ⅴ型混合菌株6株(33.3%)。结论本地区的MRSA以SCCmecⅢ型为主,MRCNS中SCCmecⅢ型、Ⅴ型混合菌株所占的比例最高,MRSA和MRCNS均对多种抗生素耐药,但都未发现对万古霉素和利奈唑胺耐药的菌株。Objective To investigate the drug resistance and SCCmec genotyping of methicilin-resistant staphylococcus aureus （MRSA） and methicillin resistant coagulates-negative staphylococci （MRCNS） in parts of Qingdao area, and provide guid- ance for rational use of antibiotics and evidence for the epidemic trend of MRSA. Methods Seventy-five strains of MRSA and 18 strains of MRCNS isolated from various kinds of clinical specimens were collected. The MicroScanWalkAway-96 automatic micro- orgnisms analyzer was used for strain identification and drug susceptibility testing, Multiplex polymerase chain reaction （PCR） was then used to detect SCCmee genotyping. Results The resistance rates of MRSA to rifampin and elindamycin were 76.0%and 81.3%, respectively, which were higher than 50.0% and 50.0% of MRCNS, the differences were significant （x^2 = 30.690,7.656; P〈0.05）. The resistance rates of MRSA to gentamycin and levofloxacin were 82.7% and 82.7%, respectively, being higher than MRCNS of 5.6% and 44.4% （x^2=6.864,9.432;P〈0.05）. Among the 75 strains of MRSA, SCCmec type Ⅲ was found in 64 （85.3%） strains, SCCmec type Ⅱ in five （6.7%） strains,and six （8.0%） strains of unknown genotype. Among the 18 strains of MRCNS, five （27.8%） strains were identified as SCCmec type Ⅲ , two （11.1%） strains as SCCmec type Ⅱ , five （27.8%） strains as SCCmec typeV , and six （33.3%） as SCCmec type Ⅲ combined with typeV strains. Conclusion In this area, main SCCmec genotype of MRSA is SCCmec type Ⅲ and the main SCCmec genotype of MRCNS is combined SCCmec type Ⅲ and type Ⅴ. Both MRSA and MRCNS have multiple resistance to commonly used antibiotics, but no strains are found to be resistant to vancomycin or linezolid.

关 键 词：耐甲氧西林金黄色葡萄球菌 耐甲氧西林凝固酶阴性葡萄球菌 葡萄球菌染色体基因盒 微生物敏感性试验 

分 类 号：R446.5[医药卫生—诊断学]