伤口分泌物金黄色葡萄球菌对MLS不同耐药表型、耐药机制及耐药性研究  

Drug Resistance, Resistant Mechanisms and Resistant Phenotypes of Staphylococcus Aureus Isolated from Wound Secretion to Macrolides–Lincosamides–Streptogramins

作　　者：王小影[1] 颜远芳[2] 陈雄艺 明德松[3] 

机构地区：[1]福建医科大学附属第二医院医疗美容科,福建泉州362000 [2]福建省安溪县医院,福建泉州362000 [3]福建医科大学附属泉州第一医院检验科,福建泉州362000

出　　处：《中国循证医学杂志》2016年第3期254-256,共3页Chinese Journal of Evidence-based Medicine

基　　金：福建省自然科学基金项目(编号:2015J01514);泉州市社会发展领域科技计划项目(编号:2014Z24);泉州市技术研究与开发项目(编号:Z[2014]0157);泉州医学高等专科学校‘国家骨干院校建设’重点资助科研项目(编号:2014XJ1313)

摘　　要：目的探讨伤口分泌物分离的金黄色葡萄球菌(Staphylococcus aureus,SA)对大环内酯类(Macrolides,M)-林可酰胺类(Lincosamides,L)-链阳菌素B(Streptogramins,S)抗生素(MLS)的不同耐药表型、耐药机制及耐药性,以指导临床用药。方法回顾性分析2008年6月至2015年10月福建医科大学附属第二医院等3家医院患者伤口分离SA及其临床资料,采用SPSS 19.0软件进行统计分析。结果共纳入127株SA,其对MLS的4种药敏表型分布为全敏感型(S)(48,37.8%)、ML型(41,32.3%)、M/iCR+型(22,17.3%)、MLS型(16,12.6%);SA耐药机制主要为靶位改变,有3种耐药表型,分别为ML型、M/iCR+型、MLS型;此外,尚未发现莫西沙星、利奈唑烷和替加环素耐药,但喹诺酮类和四环素类呈现出低耐药率。结论伤口分泌物中SA对MLS的4种药敏表型分布不同,总体药敏表型偏少,耐药性偏低。Objective To explore drug resistance, resistant mechanisms and resistant phenotypes of staphylococcus aureus（SA） isolated from wound secretion to macrolides –lincosamides –streptogramins（MLS）. Methods A retrospective design was used to collect clinical data and antimicrobial resistance profiles of SA in the First Affiliated Hospital and the Second Affiliated Hospital of Fujian Medical University and Anxi County Hospital from June, 2008 to October, 2015. SPSS 19.0 software was used for data analysis. Results A total of 127 isolates were included. The distribution of four resistant phenotypes of SA to MLS were all susceptibility（S） type（n=48, 37.8%）, ML type（n=41, 32.3%）, M/i CR＋ type（n=22, 17.3%） and MLS type（n=16, 12.6%）, respectively; There were three kinds of phenotypes caused by target changing including ML type, M/i CR＋ type and MLS type, respectively. Moreover, no moxicaxin, linezolid or tigecyline resistant strain was detected, while quinolons and tetracyclines showed low-level resistant. Conclusion Compared with the different samples, the resistant phenotypes of SA isolated from wound secretion to MLS are few, and the total resistance ratio is low.

关 键 词：伤口分泌物 金黄色葡萄球菌 大环内酯类 替加环素 喹诺酮类 四环素类 利奈唑烷 诱导性 

分 类 号：R446.5[医药卫生—诊断学]