215株MRSA的临床分布、耐药特征和耐药基因mecA检测的分析性研究  

Study of distribution,antimicrobial resistance,and mecA gene of 215 strains MRSA

作　　者：张勇[1,2] 闫志勇[1] 杨秀珍[2] 刘宏锋[2] 孙玲玲[3] 王斌[1] 

机构地区：[1]青岛大学医学院病原生物学教研室,青岛266021 [2]淄博市中心医院临床检验科 [3]淄博市第五人民医院淄博市精神卫生中心

出　　处：《滨州医学院学报》2015年第6期448-451,共4页Journal of Binzhou Medical University

摘　　要：目的通过对我院分离的MRSA进行回顾性分析,为临床合理使用抗生素提供实验室依据。方法回顾性分析我院2010年1月—2013年12月分离到的215株MRSA的耐药性,总结其科室分布、标本来源类型情况、探讨耐药性变化趋势,并通过多重PCR检测其耐药基因mecA及其同源体基因mecALGA251。结果 2010年1月—2013年12月我院MRSA的分离率呈逐年增高趋势,ICU分离的MRSA最多,标本来源以痰液标本最多。药敏试验结果表明,215株MRSA对利奈唑胺、替考拉宁和万古霉素的敏感率均为100%,对其他11种药物,包括青霉素、克林霉素、苯唑西林、头孢唑林、头孢噻肟、红霉素、环丙沙星、左氧氟沙星、庆大霉素及复方新诺明耐药率均很高,且随年份呈现增高趋势。215株MRSA通过多重PCR法均检测到mecA基因,另外有7株检测到同时含有mecALGA251基因。结论 MRSA对利奈唑胺、替考拉宁和万古霉素的敏感性很高,可用于MRSA感染的治疗。mecA基因同源体mecALGA251基因的出现,可通过多重PCR法对其进行检测。Objective MRSA which were isolated in our hospital were retrospectively reviewed to help the clinical treatment.Methods To investigate the clinical distribution,antimicrobial resistant situation,and detection mecA gene and mecALGA251 gene of MRSA,we did a retrospective analysis of 215 MRSA isolated from Jan 2010 to Dec 2013.Results MRSA isolation rates increased yearly from 2010 to 2013.MRSA were isolated from ICU ward more frequently than from other wards,and from sputum specimen than from other specimens.MRSA were high sensitive to linezolid,teicllanin and vancomycin,and were high resistance to other 11 common antibiotics,such as penicillin,clindamycin,and so on.All of the 215 MRSA were detected mecA gene,and 7 MRSA were identified mecALGA251.Conclusion Linezolid,Teicllanin,and Vancomycin are the first drugs against MRSA infection.The multiplex PCR can be applied to detect the mecALGA251 gene.

关 键 词：MRSA 耐药 MECA基因 抗生素 

分 类 号：R446.5[医药卫生—诊断学]