吉林市区耐甲氧西林金黄色葡萄球菌SCCmec基因分型与耐药性研究  

Study on antimicrobial resistance and the detection of staphylococcus chromosomal cassette mec typing of methicillin-resistant Staphylococcus aureus in the urban area of Jilin

作　　者：时文艳[1] 冯宪敏[2] 于圣[1] 于新[1] 黄红兰[1] 

机构地区：[1]吉林大学基础医学院病原生物学教研室,长春130021 [2]吉林医药学院病原生物学教研室,132013

出　　处：《中国医师进修杂志》2016年第12期1080-1083,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的了解吉林市区耐甲氧西林金黄色葡萄球菌（MRSA）的分子流行病学特征及其耐药性，为指导临床用药及控制MRSA感染提供依据。 方法收集吉林市区2013年7月至2014年7月检出的103株MRSA菌株，用多重聚合酶链反应检测葡萄球菌mec盒式染色体（SCCmec）基因型，同时用K-B法检测菌株对临床常用13种抗菌药物的敏感性，分析菌株的病区来源。 结果 SCCmec基因分型结果显示，62株为SCCmecⅢ型，占60.2%，39株为SCCmecⅡ型，占37.9%，未能分型菌株有2株，占1.9%。药敏试验结果显示，103株MRSA对头孢西丁、头孢唑啉、青霉素、苯唑西林的耐药率均为100.0%；对红霉素、左氧氟沙星、环丙沙星、四环素、庆大霉素和利福平的耐药率分别是96.1%、93.2%、95.1%、91.3%、90.3%和55.3%；对复方磺胺甲唑的耐药率低，仅为1.9%；未发现对万古霉素和替考拉宁耐药的菌株。菌株来源的科室分布排前三位分别是神经外科（31.1%）、ICU（19.4%）和烧伤整形外科（17.5%）。 结论吉林市区MRSA以SCCmecⅢ型为主要流行株，以SCCmecⅡ型为次要流行株，并且MRSA呈多重耐药，耐药性严重,但对万古霉素和替考拉宁敏感。Objective To understand the molecular epidemiology characteristics and its drug resistance of methicillin-resistant Staphylococcus aureus （MRSA） in the urban area of Jilin and to provide important basis for guiding the clinical medication and prevention of the MRSA infection. Methods One hundred and three strains of MRSA from July 2013 to July 2014 in the urban area of Jilin were selected. The polymerase chain reaction （PCR） techno]ogy and multiple polymerase chain reaction were used to detect mecA gene and Staphylococcus chromosomal cassette mec typing （SCCmec） genotype of MRSA. The drug sensitivity test for 13 kinds of clinical common antibacterial drugs were detected by using the K-B method. And the source of the strains were analyzed. Results The results of SCCmec genotype of MRSA showed that SCCmec llI type were 62 strains, accounting for 60.2%; SCCmec Ⅱ type were 39 strains, accounting for 37.9%; failing to parting were 2 strains,accounting for 1.9%. Drug susceptibility test results showed that all of 103 MRSA strains were resistant to cefoxitin, cefazolin, penicillin and benzene, and drug resistance rate was 100.0%. The resistant rate to erythromycin, levofloxacin, ciprofloxacin, tetracycline, gentamicin and rifampin were 96.1%, 93.2%, 95.1%, 91.3%, 90.3% and 55.3% receptively; the resistant rate to sulfamethoxazolewas was only 1.9%; and the resistant strains to vancomycin and teicoplanin were not detected. The top three department of the distribution of the strains source were department of neurosurgery （31.1%）, ICU （19.4%） and burn plastic surgery （17.5%）. Conclusions The SCCmec Ⅲ type is the main MRSA epidemic strains, and SCCmec type Ⅱ is a minor epidemic strainin the urban area of Jilin. The antibiotic resistance of MRSA is a serious problem with multiple drug resistance, but MRSA is sensitive to vancomycin and teicoplanin.

关 键 词：耐甲氧西林金黄色葡萄球菌 基因型 葡萄球菌mec盒式染色体 耐药性 

分 类 号：R440[医药卫生—诊断学]