耐甲氧西林金黄色葡萄球菌的SCCmec分型和耐药特点以及同源性分析  

SCCmec genotyping and drug resistance and homology of methicillin-resistant staphylococcus aureus

作　　者：张宇琼[1] 张仪 陆文香[1] 高晶晶[1] 张宇蔺 朱琴芳[1] 袁垆 徐卫东[1] 

机构地区：[1]南京医科大学附属苏州市立医院本部检验科,江苏苏州215002 [2]苏州大学,江苏苏州215002

出　　处：《现代预防医学》2018年第1期113-118,共6页Modern Preventive Medicine

基　　金：苏州市"科教兴卫"青年科技项目(项目编号:KJXW2016025)

摘　　要：目的对临床分离的耐甲氧西林金黄色葡萄球菌(MRSA)进行葡萄球菌染色体mec盒(SCCmec)分型并了解其耐药性,同时结合基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)技术对其进行同源性分析。方法收集2016年鉴定出的100株MRSA,同时加做K-B法验证耐药表型。普通PCR检测mec A基因,多重PCR进行SCCmec基因分型,MALDI-Biotyper软件进行同源性分析。结果 SCCmec分型为:SCCmecⅡ型38株(38%),SCCmecⅢ型9株(9%),SCCmecⅣ型12株(12%),SCCmec V型35株(35%),未分型6株(6%)。同源性分析结果将100株MRSA分为MS1和MS2两大群,其中MS1又分为MS1a和MS1b两个亚群。各型MRSA对替考拉宁、利奈唑胺和万古霉素的耐药率均为0,MS2群的MRSA对其他非β-内酰胺类抗生素的耐药率明显高于MS1群。结论临床分离MRSA以Ⅱ型和V型为主,多重耐药较为严重,MALDI-TOF MS技术可以准确鉴定金黄色葡萄球菌,结合SCCmec分型技术可以有效区分Ⅴ型社区感染菌株和Ⅱ型院内感染菌株。Objective To understand the drug resistance of methicillin - resistant Staphylococcus aureus （MRSA） isolated from clinical infections through SCCmec genotyping, and to conduct homology analysis combining with matrix - assisted laser desorption/ionization time -of- flight mass spectrometry（ MALDI -TOF MS）technology. Methods Totally 100 strains MRSA identified in 2016 were collected to be verified the drug resistance phenotype by K - B method. MecA gene was detected by simple PCR,and SCCmec typing and homology analysis of MRSA were conducted by multiplex PCR and MALDI- Biotype software, respectively. Results SCCmec IX , SCCmec II1, SCCmec IV, SCCmecV and unclassified typing accounted for 38% ,9% , 12% ,35% ,6% ,respectively. The 100 MRSA isolates were divided into two groups named MS1 and MS2 by MALDI -Biotype software, and MS1 was divided into two subgroups named MS1 a and MS1 b. All types of MRSA were susceptible to teicoplanin, linezolid and vancomycin. The resistance rates of MS2 to other non - beta - lactam antibiotics were significantly higher than those of MS1. Conclusion The clinical isolates of MRSA are predominantly SCCmec I/ and V,whose multiple drug resistance is relatively serious. MALDI -TOF MS can accurately identify staphylococcus aureus, and it can effectively distinguish between typeV community infection strains and type Ⅱ nosocomial infection strains combining with SCCmec typing technology.

关 键 词：耐甲氧西林金黄色葡萄球菌 基质辅助激光解吸/电离飞行时间质谱 SCCmec分型 同源性分析 

分 类 号：R117[医药卫生—公共卫生与预防医学]