感染性心内膜炎患者表皮葡萄球菌感染状况及喹诺酮类药物耐药机制研究  

Staphylococcus epidermidis infection status and quinolones resistance mechanism of patients with infective endocarditis

作　　者：李徽[1] 王春彤 赵占秋 郭晓红[2] 高春明[1] 

机构地区：[1]周口市西华县人民医院心内科,河南周口466600 [2]周口市西华县人民医院康复科,河南周口466600

出　　处：《中华医院感染学杂志》2016年第24期5548-5550,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技厅科技发展计划(1233064114252)

摘　　要：目的研究感染性心内膜炎患者表皮葡萄球菌感染状况及喹诺酮类药物耐药机制,为表皮葡萄球菌临床抗菌用药的选择提供参考。方法选取医院2014年1月-2015年12月诊治132例感染性心内膜炎患者,采集血液标本,培养分离感染病原菌,进行药敏试验及最低抑菌浓度(MIC)测定,检测表皮葡萄球菌对喹诺酮类抗菌药物的耐药性,同时采用PCR扩增gyrA基因及测序,分析结果。结果 132例患者有36例分离出表皮葡萄球菌,感染率为27.27%;表皮葡萄球菌对诺氟沙星耐药率为100.00%;表皮葡萄球菌PCR扩增gyrA基因产物长度275p,部分菌株同时存在多点位突变。结论表皮葡萄球菌是引起感染性心内膜炎的主要感染病原菌,对大部分喹诺酮类药物普遍存在耐药,耐药的表皮葡萄球菌株存在gyrA基因变异,这可能是其对喹诺酮类药物产生耐药的机制之一。OBJECTIVE To study Staphylococcus epidermidis infection status and quinolones resistance mechanism of patients with infective endocarditis,so as to provide references for the selection of clinical antibacterial drugs of S.epidermis.METHODS A total of 132 cases patients with infective endocarditis in the hospital from Jan.2014 to Dec.2015 were selected.The blood specimens were collected,pathogens were cultured and separated,drug sensitive test was carried,minimum inhibitory concentration（MIC）was determined,drug resistance of S.epidermidis to quinolones were detected,gyrAgene was amplified and sequenced by PCR,and the results were analyzed.RESULTS Totally 36 cases of patients occurred S.epidermidis infection in 123 cases of patients,with the infection rate of 27.27%.The drug resistant rate of S.epidermidis to norfloxacin was 100.00%.The length of PCR amplification of gyrAgene product was 275 bp.Some of the strains had multiple-point mutations at the same time.CONCLUSION S.epidermidisis a major pathogen causing infective endocarditis.For the majority of quinolones is widespread drug resistance.Resistant S.epidermidis exists gyrAgene variation.Drug resistant S.epidermidis exists gyrAgene variant,and this may be one of the mechanisms of resistance to quinolones.

关 键 词：感染性心内膜炎 表皮葡萄球菌 喹诺酮 

分 类 号：R378.11[医药卫生—病原生物学]