耐甲氧西林金黄色葡萄球菌mecA基因的临床研究  

Clinical study on detection of mecAgene for methicillin-resistant Staphylococcusaureus

作　　者：林丽娟[1] 邢珍珍[1] 姜长宏[1] 陈晓娇[1] 钟晓祝[2] 余楠[1] 

机构地区：[1]南方医科大学珠江医院检验医学部,广东广州510282 [2]南方医科大学珠江医院医院感染科,广东广州510282

出　　处：《中华医院感染学杂志》2016年第3期509-511,515,共4页Chinese Journal of Nosocomiology

基　　金：国家重大科技专项基金资助项目(2013ZX10004805-004)

摘　　要：目的比较荧光定量PCR法和传统细菌培养药敏试验两种方法鉴定耐甲氧西林金黄色葡萄球菌(MRSA)的能力,评估荧光定量PCR直接检测不同类型标本中MRSA的mecA基因是否具有临床应用价值。方法收集2013年11月-2014年11月经细菌培养和纸片药敏试验确定为金黄色葡萄球菌的111份临床标本,荧光定量PCR法检测标本的mecA基因,比较两种方法结果。结果两种方法具有较好一致性、吻合度,差异有统计学意义;以传统方法为对照,荧光定量PCR直接检出MRSA的敏感性为100.0%、特异性90.9%;PCR检出痰液标本的MRSA的敏感性为100.0%、特异性100.0%;PCR检出其他标本的MRSA的敏感性为100.0%、特异性81.8%;mecA基因直接检测与传统方法不一致的全部为血培养标本,但分离菌落基因检测与药敏结果一致。结论荧光定量PCR直接检测临床标本mecA基因用于筛查MRSA可靠,临床微生物实验室可推广以早期控制医院感染和指导临床抗菌药物使用。OBJECTIVE To compare the performance of the real-time polymerase chain reaction（PCR）and the traditional bacterial culture and sensitivity test for identification of methicillin-resistant Staphylococcus aureus（MRSA）so as to evaluate the clinical application value of PCR for direct detection of mecAgene in MRSA from varied clinical specimens.METHODS A total of 111 clinical specimens,collected from Nov.2013 to Nov.2014 in our hospital and identified with S.aureusinfections by bacterial culture and disc diffusion test,was screened for mecA gene of MRSA using real-time PCR.The results of the two methods were compared.RESULTS The results by real-time PCR targeting mecAgene directly from specimens were consistent with those by the traditional method for MRSA detection,with statistical significance.Comparing to the traditional method,the specificity and the sensitivity of real-time PCR was 90.9% and 100.0%,respectively.As for the sputum specimens,the specificity and the sensitivity of MRSA detection by PCR was 100.0% and 100.0%respectively.Meanwhile,the specificity and the sensitivity of real-time PCR for non-sputum specimens was 100.0% and 82.0%,respectively.The inconsistent results of direct mecAgene detection to the traditional method were all from blood specimens,however,the results for isolated colony of bacteria by the two assays were consistent.CONCLUSIONThe real-time PCR targeting the mecAgene was reliable for detection of MRSA directly from clinical specimens,which can be widely used in clinical microbiological laboratories for early control of hospital infection and guidance of clinical antibiotic use.

关 键 词：耐甲氧西林金黄色葡萄球菌 荧光定量聚合酶链反应 MECA基因 药敏试验 

分 类 号：R378.11[医药卫生—病原生物学]