患儿感染耐甲氧西林凝固酶阴性葡萄球菌耐药性及基因分型研究  

Antibiotic resistance and genotypes of methicillin-resistant coagulase-negative Staphylococci in children

作　　者：蒲海波[1] 杨乐[2] 李海涛[3] 薄延桥 徐东克 

机构地区：[1]南阳医学高等专科学校第一附属医院儿三科,河南南阳473058 [2]南阳医学高等专科学校基础医学部,河南南阳473000 [3]南阳医学高等专科学校第一附属医院儿科,河南南阳473058 [4]南阳医学高等专科学校第一附属医院儿一科,河南南阳473058

出　　处：《中华医院感染学杂志》2017年第23期5468-5471,共4页Chinese Journal of Nosocomiology

摘　　要：目的调查研究患儿感染耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)耐药性及基因分型,为MRCNS感染的抗菌药物选择、NRCNS感染的防治提供科学参考依据。方法收集2011年1月-2016年12月期间儿科164例感染性疾病患儿送检的164份临床标本,行菌株培养、表型筛选;采用标准琼脂倍比稀释法对MRCNS进行抗菌药物最低抑菌浓度(MIC)检测,确定耐药状况;采用聚合酶链反应(PCR)扩增基因检测葡萄球菌染色体mec基因盒(SCCmec)各分型。结果 164份标本中共检出78株MRCNS,检出率为47.56%;其中耐甲氧西林表皮葡萄球菌(MRSE)35株占44.87%,耐甲氧西林溶血性葡萄球菌(MRSH)19株占24.36%,耐甲氧西林人葡萄球菌(MRSHo)10株占12.82%;MRCNS对青霉素、头孢哌酮、头孢曲松、头孢噻肟、亚胺培南均完全耐药,耐药率为100.00%,对红霉素、阿奇霉素、克林霉素的耐药率均>80.00%,对万古霉素完全敏感,耐药率为0;MRCNS的SCCmec基因分型Ⅰ~Ⅵ型有检出,Ⅶ~Ⅷ型未检出,其中Ⅲ型基因38株占48.72%,混合型19株占24.36%,7株IV型占8.97%。结论患儿感染性疾病时MRCNS检出率较高,MRCNS对临床常用的多种抗菌药物耐药率高,具有多药耐药性,MRCNS所携带的SCCmec基因型主要为Ⅲ型及混合型,以上基因可能与MRCNS耐药关系密切。OBJECTIVE To investigate antibiotic resistance and genotypes of methicillin-resistant coagulase-negative Staphylococci（MRCNS）in children,so as to provide scientific references for selection of of antimicrobial agents for MRCNS infection and prevention and treatment of NRCNS infections.METHODS A total of 164 clinical specimens of 164 cases of children with infectious disease from Jan.2011 to Dec.2016 were selected,and strain cultivation and phenotypic screening were carried out.Minimal inhibitory concentrations（MIC）of antibiotics were determined by adopting agar dilution method,and the drug resistance status was determined.The SCCmec types were detected by PCR method.RESULTS Totally 78 strains of MRCNS were detected in 164 clinical specimens,and the detection rate was 47.56%.There were 35 strains of MRSE,accounting for 44.87%,19 strains of MRSH were,accounting for 24.36%,and 10 strains of MRSHo,accounting for 12.82%.The analysis of antibiotic resistance showed the antimicrobial resistant rates of MRCNS to penicillin,cefoperazone,ceftriaxone,cefotaxime and imipenem were all 100.00%,and to erythromycin,azithromycin,ciprofloxacin and clindamycin were all greater than80.00%.MRCNS was sensitive to vancomycin completely,and the drug resistant rate was 0.SCCmec genotypes of I to VI were detected from 78 MRCNS strains,type VII and VIII were not detected,among which type III were38 strains,mixed type were 19 strains,and IV type were 7 strains,accounting for 48.72%,24.36% and 8.97%,respectively.CONCLUSION MRCNS detection rate is high in children with infectious diseases,MRCNS have high resistant rates to many kinds of commonly used antibiotics,and shows multi-drug resistance.SCCmec genotypes are mainly III type and mixed type,which may be closely associated with drug resistance of MRCNS.

关 键 词：感染耐甲氧西林凝固酶阴性葡萄球菌 耐药性 基因 患儿 

分 类 号：R378[医药卫生—病原生物学]