社区糖尿病人群携带金黄色葡萄球菌的分型与耐药谱关系研究  

The relationship between Staphylococcus aureus strains types and antimicrobial susceptibility patterns among patients with diabetes mellitus in communities

作　　者：徐萍[1] 雷燕 姚振江[1] 赵新华[1] 

机构地区：[1]广东药学院公共卫生学院,广东广州510000 [2]佛山市南海区第三人民医院社区卫生科,广东佛山528244

出　　处：《现代预防医学》2016年第2期292-295,共4页Modern Preventive Medicine

基　　金：佛山市卫生局医学科研项目(项目编号:2014297)

摘　　要：目的了解社区糖尿病人群携带金黄色葡萄球菌的分型情况并分析其耐药谱。方法随机抽取佛山市里水镇11个社区糖尿病人438名并收集其鼻拭子样本,根据传统实验室方法分离鉴定金黄色葡萄球菌,采用头孢西丁纸片扩散法和mec A基因扩增法进行耐甲氧西林金黄色葡萄球菌(Methicillin-Resistant Staphylococcus Aureus,MRSA)的鉴定,利用多重聚合酶链式反应(Polymerase Chain Reaction,PCR)的方法对MRSA菌株进行葡萄球菌染色体盒(Staphyloccoccal Cassette Chromosome mec,SCCmec)的分子分型,应用K-B纸片扩散法分析金黄色葡萄球菌的耐药谱。结果 438份样本中分离出43株金黄色葡萄球菌,检出率为9.82%,其中22株(5.02%)为MRSA。22株MRSA中,医院获得性耐甲氧西林金黄色葡萄球菌(Hospital-Acquired MRSA,HA-MRSA)7株,社区获得性耐甲氧西林金黄色葡萄球菌(Community-Acquired MRSA,CA-MRSA)10株,SCCmec未分型5株。金黄色葡萄球菌除对替考拉宁无耐药外,对其他抗生素均有不同程度的耐药,MRSA的耐药率普遍高于甲氧西林敏感金黄色葡萄球菌(Methicillin Sensitive Staphylococcus Aureus,MSSA)的耐药率,两者对红霉素和克林霉素耐药率差异有统计学意义,36.36%(8/22)的MRSA具有多重耐药性,MSSA中未发现多重耐药菌株。结论该地区糖尿病人群携带的金黄色葡萄球菌中MRSA比例高,所携带的MRSA中以CA-MRSA为主,MRSA对抗生素的多重耐药问题值得重视。Objective The aim of this study was to identify the types and antimicrobial resistance patterns of Staphylococcus aureus among patient with diabetes melIitus. Methods Random sampling method was employed to select diabetes mellitus patients in 11 communities of Foshan Lishui and nasal swabs were also collected at the same time. Staphylococcus aureus was identified according to conventional laboratory methods. Cefoxitin disk diffusion test and mecA gene PCR assay were applied to detect MRSA. The SCCmec typing of MRSA was conducted by multiplex PCR assay and the antimicrobial susceptibility to ten kinds of antibiotics of Staphylococcus aureus were tested by K-B disk diffusion. Results A total of 43 （9.82%） Staphylococcus aureus strains were isolated from the nasal swabs of the 438 patients, in which 22 （5.02%） were MRSA. In the 22 MRSA strains, seven strains were defined as HA-MRSA and ten isolates were classified as CA-MRSA. Staphylococcus aureus had different resistance rates to different antibiotics. No strain was resistant to teicoplanin. The resistance rates of MRSA were higher than that of MSSA commonly. 36.36% （8/22） of MRSA had multiple drug resistance. Conclusion This study demonstrated that the nasal carriage rate of MRSA among Staphylococcus aureus in diabetes meUitus patients was high. The major type of MRSA was CA-MRSA. The problem of multi-resistant to antibiotics in MRSA should not be ignored.

关 键 词：糖尿病人群 金黄色葡萄球菌 耐药谱 

分 类 号：R378[医药卫生—病原生物学]