携带psm-mec基因耐甲氧西林表皮葡萄球菌的耐药谱研究  

Antimicrobial resistance profile analysis of MRSE with psm-mec gene

作　　者：杨永长[1] 肖代雯[1] 喻华[1] 姜伟[1] 陈亮[1] 胡洪华[1] 周薇[1] 黄文芳[1] 

机构地区：[1]四川省医学科学院.四川省人民医院检验科,四川成都610072

出　　处：《实用医院临床杂志》2015年第6期31-34,共4页Practical Journal of Clinical Medicine

摘　　要：目的比较携带与未携带psm-mec基因耐甲氧西林表皮葡萄球菌(MRSE)的耐药谱,为治疗MRSE引起的感染提供理论依据。方法收集临床分离并经过全自动微生物奠定系统准确鉴定的表皮葡萄球菌(Staphylococcus epidermidis,S.epidermidis)165株,通过PCR扩增esp和mec A基因,准确鉴定和区分甲氧西林敏感表皮葡萄球菌(MSSE)和MRSE。扩增psm-mec,fudoh和p221片段确认携带psm-mec基因的MRSE菌株,比较分析携带与未携带psm-mec基因MRSE的耐药谱。结果83.64%的临床分离S.epidermidis为MRSE,其中29株携带psm-mec基因,携带率为17.58%,且仅分布于MRSE中。临床分离MRSE易对苯唑西林、青霉素、红霉素、复方新诺明和克林霉素耐药,未发现对利奈唑胺、呋喃妥因、普丁/达福、万古霉素和替加环素耐药菌株。携带psm-mec基因MRSE对环丙沙星、庆大霉素、利福平和复方新诺明的耐药率明显高于未携带psm-mec基因MRSE。结论携带psm-mec基因MRSE易对苯唑西林、青霉素、红霉素、克林霉素、环丙沙星、庆大霉素、利福平和复方新诺明耐药。Objective To compare the antimicrobial resistance profiles between MRSE with and without psm-mec gene in order to provide foundation for treatment of MRSE infection disease. Methods One hundred and sixty five strains of S. epidermidis identified accurately by full automation microbiological identification system were collected. PCR was used to amplify esp and mec A gene to differentiate methicillin-resistant S. epidermidis（ MRSE） and methicillin-sensitive S. epidermidis（ MSSE）. Strains with psm-mec gene were validated by amplification of psm-mec,fudoh and p221 fragments,and antimicrobial resistance profile of MRSE with or without psm-mec gene was analyzed. Results MRSE accounted for 83. 64% of clinical isolated S. epidermidis,and 29 strains were positive for psm-mec gene with a rate of 17. 58%,which were distributed only in MRSE. Clinical isolates of MRSE were usually resistant to oxacillin,penicillin,erythromycin,compound sulfamethoxazole and clindamycin,but no strains resistant to linezolid,furantoin,quinupristin /dalfopristin,vancomycin and tigecycline were found. The rate of MRSE with psm-mec gene resistant to ciprofloxacin,gentamicin,rifampin and compound sulfamethoxazole was higher than that of MRSE without psm-mec. Conclusion MRSE with psm-mec gene are more likely resistant to oxacillin,penicillin,erythromycin,clindamycin,ciprofloxacin,gentamicin,rifampin and sulfamethoxazole-trimethoprim.

关 键 词：耐甲氧西林表皮葡萄球菌 psm-mec 耐药谱 

分 类 号：R446.5[医药卫生—诊断学]