金黄色葡萄球菌pvl基因的检测与耐药性分析  

Pvl gene detection and resistance analysis of Staphylococcus aureus

作　　者：孙丽媛[1] 武昕媛 李明成[1] 李钰[2] 张艳杰[2] 赵云冬[1] 

机构地区：[1]北华大学医学检验学院微生物学检验教研室,吉林吉林132013 [2]北华大学附属医院检验科,吉林吉林132011

出　　处：《中华医院感染学杂志》2015年第20期4564-4566,4569,共4页Chinese Journal of Nosocomiology

基　　金：吉林省教育厅"十二五"科学技术研究基金资助项目(2013-172)

摘　　要：目的探讨临床分离的金黄色葡萄球菌杀白细胞素基因的携带及对常见抗菌药物的耐药性,为临床合理使用抗菌药物提供病原学依据。方法临床于2013年6-12月分离金黄色葡萄球菌180株,PCR法扩增其mecA、femB、pvl基因,并对其耐药性采用AST GP67药敏试剂盒进行检测。结果 180株临床分离的金黄色葡萄球菌中检出MRSA 112株占62.2%、MSSA 68株占37.8%;分离的金黄色葡萄球菌中有8株pvl基因检测阳性,阳性率4.44%;MRSA对庆大霉素、克林霉素、红霉素、利福平、四环素耐药率均达>80.0%;MSSA对克林霉素、红霉素、四环素耐药率达>30.0%,对庆大霉素耐药率为19.1%,对利福平耐药率仅为8.8%,与MRSA耐药率比较,差异有统计学意义(P<0.05);MSSA较MRSA诱导克林霉素耐药高,差异有统计学意义(P<0.05)。结论临床分离的金黄色葡萄球菌pvl基因携带率较低,但耐药问题严重,MRSA对所有β-内酰胺类抗菌药物耐药,同时对大环内酯类、四环素类、林可霉素、氨基糖苷类、利福平耐药率明显高于MSSA,今后应加强耐药基因的监测有效控制MRSA感染流行。OBJECTIVE To investigate the carrying of panton‐valentine leukocidin （PVL ） and drug resistance of Staphylococcus aureus so as to provide etiological evidence for reasonable use of antibiotics .METHODS Totally 180 strains of S .aureus were clinically isolated from Jun .2013 to Dec .2013 .The genes of mecA ,femB and pvl were amplified with PCR .The drug susceptibility was tested by AST GP67 testing kit .RESULTS Totally 112 MRSA strains and 68 MSSA strains were identified from the 180 clinical isolates .Among the 180 isolates ,8 strains were detected as carrying pvl gene ,with the positive rate of 4 .44% .MRSA had a resistant rate of over 80 .0% to gentamicin ,clindamycin ,erythromycin ,rifampin and tetracycline .MSSA had a resistant rate of over 30 .0% to clindamycin ,erythromycin and tetracycline ,19 .1% to gentamicin and only 8 .8% to rifampin .There was a significant difference in resistant rate between MRSA and MSSA （P＜0 .05） .MSSA had significant higher resist‐ance to clindamycin than MRSA （P＜0 .05） .CONCLUSION The carrying rate of pvl gene was low for S .aureus , however ,these isolates showed serious resistance .MRSA were resistant to all β‐lactam antibiotics and showed higher resistance to macrolides ,tetracyclines ,lincomycin ,aminoglycosides and rifampicin than MSSA .In the fu‐ture ,clinicians should further strengthen the monitoring of resistant genes and take effective measures to control the infection of M RSA .

关 键 词：耐甲氧西林金黄色葡萄球菌 甲氧西林敏感金黄色葡萄球菌 杀白细胞素 耐药性 

分 类 号：R378.11[医药卫生—病原生物学]