106株耐甲氧西林金黄色葡萄球菌耐药性分析与SCCmec基因分型及pvl基因研究  

Antibiotic resistance,staphylococcal cassette chromosome mec genotype and pvl gene in 106 strains of meticillin-resistant Staphylococcus aureus

作　　者：徐银海[1] 纵帅[1] 顾兵[1] 徐萍萍[2] 丁宸[2] 寇艳波 王莹宇 

机构地区：[1]徐州医学院附属医院检验科,江苏徐州221002 [2]徐州市中心医院检验科,江苏徐州221002 [3]徐州医学院感染与免疫实验室,江苏徐州221004

出　　处：《中华医院感染学杂志》2016年第20期4561-4564,共4页Chinese Journal of Nosocomiology

基　　金：徐州市科技基金资助项目(KC14SH116);江苏省自然科学基金资助项目(BK20151154)

摘　　要：目的研究医院感染分离的耐甲氧西林金黄色葡萄球菌(MRSA)耐药性,对葡萄球菌染色体mec(SCCmec)基因进行分型,并检测杀白细胞素(PVL)毒力基因,以明确MRSA耐药表型和流行病学特征,为临床治疗提供参考。方法收集2011-2014年金黄色葡萄球菌(SAU)179株并鉴定出MRSA,采用K-B法进行耐药表型检测,多重PCR进行SCCmec基因分型,普通PCR检测pvl基因携带情况。结果 179株SAU中共鉴定出106株MRSA,检出率为59.2%;MRSA对万古霉素、喹奴普汀/达福普汀、利奈唑胺和替考拉宁耐药率为0,对利福平、磺胺甲噁唑/甲氧苄啶和呋喃妥因的耐药率分别为43.4%、21.7%和4.8%,对其他抗菌药物耐药率均>50.0%;106株MRSA被分为3个型别,其中SCCmecⅢ型77株(72.6%),SCCmecⅡ型11株(10.4%),SCCmecⅣ型2株(1.9%),未分型16株(15.1%);4株MRSA被检出pvl基因阳性,携带率为3.8%。结论 MRSA总体呈严重的多药耐药性,未发现万古霉素耐药株;临床MRSA分离株以SCCmecⅢ型为主,Ⅱ型次之;应重点关注携带pvl基因的SCCmecⅢ型多药耐药MRSA株。OBJECTIVE To investigate antibiotic resistance, staphylococcal chromosomal cassette mec （SCCmec） genotypes,and Panton-Valentine leukocidin （PVL） gene in methicillin-resistant Staphylococcus aureus （MRSA） i- solated from hospital infections, so as to make clear the MRSA resistant phenotypes and epidemiological character- istics and provide the reference for clinical treatment. METHODS MRSA was identified from 179 strains of S. au- reus that were collected from 2011 to 2014. The drug resistance was detected by the K-B test. The genotypes of SCCmec were determined by multiplex PCR and the pvl gene was detected by simple PCR. RESULTS A total of 106 strains of MRSA were identified from 179 strains of SAU, with the detection rate of 59.2%. The strains of MRSA were sensitive to vancomycin, quinupristin/dalfopristin, linezolid and teicoplanin completely. The drug re- sistant rates of MRSA to rifampin, compound sulfamethoxazole and nitrofurantoin were 43. 4%, 21. 7% and 4.8 respeetively,while to another antibiotics were above 50%. Among 106 isolates of MRSA, SCCmec Ⅲ,SCCmecⅡ ,SCCmec Ⅳand nontypeable isolates were accounted for 72.6 % （77/106）, 10.4 % （11/106）, 1.9 % （2/106） and 15.1% （16/106）, respectively. Totally 4 strains of MRSA were pvl gene positive, with the carrying rate of 3.8 %. CONCLUSIONS MRSA has got a serious multi-drug resistance, but no strain is resistant to vancomycin. The major SCCmec genotype of MRSA is SCCmeclⅡ, and the secondary genotype is SCCmec Ⅱ. We should focus on the multi-drug resistant strains of SCCmec type Ⅲ MRSA that carrying the pvl gene especially.

关 键 词：耐甲氧西林金黄色葡萄球菌 葡萄球菌染色体mec盒 杀白细胞素 

分 类 号：R378.11[医药卫生—病原生物学]