澳门特别行政区医院金黄色葡萄球菌耐药性分析及杀白细胞素基因的检测  

Analysis of antimicrobial resistance of Staphylococcus aureus and detection of Panton-Valentine Leukocidin(PVL)gene in Macao Special Administrative Region

作　　者：叶千红[1] 吴许文[2] 李沛樟 

机构地区：[1]澳门理工学院高等卫生学校,中国澳门特别行政区999078 [2]澳门镜湖医院检验科,中国澳门特别行政区999078

出　　处：《中华医院感染学杂志》2017年第24期5525-5529,共5页Chinese Journal of Nosocomiology

摘　　要：目的了解澳门临床分离的金黄色葡萄球菌(S.aureus)对常用抗菌药物的耐药情况及耐甲氧西林金黄色葡萄球菌(MRSA)的感染率;了解MRSA菌株中杀白细胞素(PVL)基因存在的情况。方法收集2015年11月-2016年4月期间澳门某综合医院临床分离S.aureus 122株;利用Vitek2药敏卡检测S.aureus对常用16种抗菌药物的耐药情况,采用头孢西丁纸片扩散法检测MRSA的表型;PCR法进行mecA基因及PVL基因的检测。结果 122株临床分离的S.aureus样本中,对苄青霉素、红霉素、克林霉素耐药率较高,均>50%;其中MRSA有49株占40.2%,MRSA组耐药率高于MSSA组,且有9种药物组间差异有统计学意义(P<0.05);MRSA中38株占77.6%mecA基因呈阳性;MRSA中23株占46.9%携带PVL基因,主要分布在脓汁、分泌物样品中,菌株主要来自18~64岁感染者,且以社区获得性MRSA(CA-MRSA)为主占65.2%。结论澳门S.aureus对常用抗菌药物耐药率、MRSA感染率均较高;MRSA中mecA基因的检出率较低,PVL基因的检出率偏高。OBJECTIVE To investigate the resistance of Staphylococcus aureus isolated from clinical hospital in Macao to common antibiotics,and the infection rate of MRSA;and to investigate the prevalence of Panton-Valentine Leukocidin（PVL）gene in MRSA strains.METHODS A total of 122 strains of S.aureus were collected from Nov.2015 to Apr.2016 in a general hospital in Macao.The resistance of S.aureus to common antibiotics was detected by Vitek 2 and the phenotype of MRSA was detected by cefoxitin disk diffusion method.The mecA gene and PVL gene were detected by PCR.RESULTS Among the 122 strains of S.aureus,the resistant rates to benzylpenicillin,erythromycin and clindamycin were high,which were all above 50%.Among them,there were 49 strains of MRSA,accounting for 40.2%.The drug resistant rates of MRSA group were higher than those of MSSA group,and there were significant differences between the groups of 9 drugs（P〈0.05）.There were 38（78%）strains of positive mecA gene detected from MRSA strains,and 23（46.9%）MRSA strains were carrying the PVLgene,which were mainly distributed in the pus and secretions samples.The high incidence was found in the samples from the patients aged 18~64 group and mainly distributed in CA-MRSA strains（65.2%）.CONCLUSIONThe high prevalence of S.aureus resistance to common antibiotics and the MRSA infectious rate are found in Macao.The prevalence of mecA gene in MRSA is low and the detection rate of PVL gene is high.

关 键 词：金黄色葡萄球菌 耐甲氧西林金黄色葡萄球菌 杀白细胞素 MECA 澳门 

分 类 号：R378.1[医药卫生—病原生物学]